Term
| Through precise embryological events, the ______ becomes fixed in the left upper abdomen while the ____ is anchored in the right lower quadrant. |
|
Definition
duodenojejunal junction
cecum |
|
|
Term
| The primary problem in malrotation. |
|
Definition
| Narrow based mesentery with midgut not adequately fixed to the posterior abdominal wall |
|
|
Term
| Rotational anomalies may be isolated, or may occur with (these 3 important congenital malformations). |
|
Definition
Gastroschisis
Ompalocele
Congenital diaphragmatic hernia |
|
|
Term
| The first definitive open surgical procedure for malrotation. |
|
Definition
|
|
Term
| During rotation, the ______ serves as the fulcrum with the ______ at the apex. |
|
Definition
Superior mesenteric artery
Omphalomesenteric duct |
|
|
Term
| In non-rotation, the duodenojejunal limb lies in the ______ with the cecocolic limb in the _____. |
|
Definition
right hemi-abdomen
left hemi-abdomen |
|
|
Term
| In incomplete rotation where does the cecum usually lie? |
|
Definition
| In the right upper quadrant |
|
|
Term
| In-utero volvulus may lead to .... |
|
Definition
|
|
Term
| ______ remains the cardinal sign of neonatal intestinal obstruction, and ____ must be the presumed diagnosis until proven otherwise. |
|
Definition
Bilious vomiting
Malrotation |
|
|
Term
| In malrotation, the inconsolable infant may rapidly deteriorate as ______ quickly advances to _____. |
|
Definition
metabolic acidosis
hypovolemic shock |
|
|
Term
| Late signs of volvulus include (3 signs) from progressive mucosal ischemia. |
|
Definition
Abdominal wall erythema
Hematemesis
Melena |
|
|
Term
| When performing an upper GI series (after performing plain films), to look for volvulus of malrotation, identification of the location of this anatomic structure has the highest sensitivity. |
|
Definition
|
|
Term
| The patient with suspected or confirmed midgut volvulus should be... |
|
Definition
resuscitated
given IV broad-spectrum abx
taken emergently to the OR |
|
|
Term
| If perfusion of a detorsed bowel remains in question, what are 2 diagnostic intraoperative options? |
|
Definition
Doppler probe
Florescein and Wood's lamp |
|
|
Term
| Six key elements in operative correction of malrotation. |
|
Definition
Entry and evisceration
Counterclockwise detorsion
Division of Ladd's cecal bands
Broaden small intestine mesentery
Incidental appendectomy
Small bowel along right lateral gutter, colon on left lateral gutter |
|
|
