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Incomplete turn of the intestine
Last reviewed: 23.04.2024
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An unfinished turn of the intestine is a condition in which the normal process of development of the intestine is broken in the intrauterine period and it does not occupy its normal place in the abdominal cavity.
During embryonic development, the primitive intestine emerges from the abdominal cavity. When he returns, the large intestine normally turns counter-clockwise, the cecum takes its place in the lower right quadrant. An incomplete turn in which the cecum is located elsewhere (usually in the upper right quadrant or epigastrium) can lead to intestinal obstruction due to retroperitoneal strands stretched across the duodenum, or due to a small bowel turn that, in the absence of a normal peritoneal attachment, is twisted on his narrow, mesentery mesentery.
[Symptoms of an incomplete bowel turn
Clinical manifestations in patients with incomplete turnaround may appear in the first year of life or in adulthood and include acute abdominal pain and vomiting with an admixture of bile, a sharp turn of the bowel, typical reflux symptoms or chronic abdominal pain. Vomiting with an admixture of bile in a child of the first year of life is an urgent situation and requires an emergency examination to ensure that the child does not have an incomplete turn or turn of the mid-gut; if untreated, the risk of developing a bowel infarction and subsequent short bowel syndrome or death is very high.
Diagnosis of incomplete bowel rotation
Survey radiography of the abdominal cavity should be performed immediately. If there is a dilatation of the small intestine and / or a small amount of air distal to the duodenum, this indicates a turn in the midgut, and further diagnosis and treatment should be carried out immediately. An enema with barium usually shows an incomplete turn, when the cecum is located outside the right lower quadrant. If the diagnosis remains unclear, serial pictures of the upper gastrointestinal tract should be performed with precautions.
Treatment of incomplete bowel rotation
An incomplete bowel turn and an inversion of the midgut is an emergency situation that requires an urgent operation, which consists of Ledd's operation with the destruction of the peritoneum cords and the elimination of the inversion of the mid-gut.