ABSTRACT
References 282
1. INTRODUCTION
Embryologic errors that lead to abnormalities of rotation and fixation of the intestine constitute
a unique group of surgical anomalies that are managed by the pediatric surgeon. Intestinal mal-
rotation and faulty fixation of the bowel, which may lead to the development of bowel obstruc-
tion or midgut volvulus and have life-threatening consequences, must be differentiated from
nonrotation, an abnormality that does not require surgical correction and is not associated with
the risk of volvulus. The incidence of intestinal malrotation has been reported with a frequency
of 1 in 500 to 1 in 6000 (2,3). Intestinal rotation or fixation abnormalities are associated with a
high incidence of other associated congenital anomalies (3). Most patients diagnosed with
malrotation will present with symptoms in the neonatal period, but problems may not occur
until late in childhood or as adults (3). The presence of such an anomaly requires the
prompt attention of a pediatric surgeon due to the risk of midgut volvulus.
