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Malrotation Study
Malrotation Study from Ashcraft's
15
Medical
Professional
09/02/2012

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Cards

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
The Ladd procedure
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
intestinal atresia.
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
Ligament of Treitz
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
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