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Surgery - management of Intestinal malrotation in the neonate

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Intestinal malrotation occurs as a consequence of failure of the fixation of bowel inside the abdominal cavity. It can occur rapidly and present with an acute abdominal emergency, or may be more subtle with intermittent bilious vomiting.

Preoperative care of infants with Intestinal Malrotation

  1. Follow standard steps for preoperative care
  2. Initial management is as per Duodenal Obstruction
  3. Fluid and electrolyte deficits must be corrected. 
  4. If midgut strangulation is present, rapid resuscitation is carried out, with operation following as soon as possible.

Postoperative care of infants with Intestinal Malrotation

Follow the steps below to ensure safety of baby is maintained post-operatively.

  1. Follow standard steps for postoperative care
  2. Management is as per Duodenal Obstruction.
  3. Parenteral nutrition may be necessary for an extended period of time if there is malabsorption or if a long segment of ischaemic intestine has been removed. 

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Document Control

  • Date last published: 03 January 2005
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years