2. • Bile stained vomitus
• Delayed BO >24 hrs after born
• Colicky abdominal pain
- Intermittent crying
• Abdominal distention
2
3. Stomach outlet Small intestine Large intestine
• Vomiting severe,
projectile
• Loss of electrolytes
• Dehydrated
• Vomiting less
severe
• Loss of electrolytes
and bile
• Dehydrated
• Very less vomiting
• Abdominal
distention
• Fail to pass stool
3
7. • 1:500 births (US)
• Intestinal non rotation or incomplete rotation around the
superior mesenteric artery
• Malrotation is often not evident until the baby
experiences a twisting of the intestine known as a
volvulus
• In the hands of experienced ultrasonographers,
ultrasonography has been shown to be very sensitive
(approximately 100%) in detecting neonatal malrotation
7
8. 8
In this upper GI series with
abnormal results, the duodenum
does not cross the midline, and
the small bowel is present only
in the right side of the abdomen
These 2 lower GI series show the
cecum (arrows) in the right upper
quadrant, indicative of malrotation
9. • Telescoping of one portion of intestine to another
• 1:2000 births (US)
• Bloody jelly stool
• Nonoperative reduction with a therapeutic enema/air. Its
contraindications are peritonitis and any evidence of
perforation on plain x ray
9
11. • Fluid and electrolyte replacement
• NBM and NG tube decompression
• Early surgical consultation
• Indications for emergeny laparotomy
• Malrotation with or without midgut volvulus
• Pneumoperitoneum
• Irreducible intussusception
• Peritonitis
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