Management and Outcome of Intestinal Malrotation in Paediatric Age Group in Paediatric Surgery Centers in Sudan from March 2019 to March 2020

Background: Intestinal malrotation is a congenital abnormality of intestinal rotation and fixation that is of great interest to paediatric surgeons because it can produce volvulus of the midgut, which can have disastrous effects if diagnosed too late. This study assessed the outcomes of intestinal malrotation in paediatric surgery centers in Sudan. Methods: Medical records of all paediatric patients with symptomatic malrotation who underwent open Ladd's surgery between March 2019 and March 2020 were evaluated in this retrospective cross-sectional study. The following patient variables were assessed: age, length of symptoms, clinical presentation, imaging, related anomalies, complications, and mortality. Chi-square analysis, association, and regression tests were performed to compare the groups, with a significance level of p <0.05. Results: The Open Ladd’s operation was performed in 57 patients (41 males and 16 females). Bilious vomiting accounted for 70.2% of the presenting symptoms, whereas most patients (54.4%) were neonates. Seven patients had midgut volvulus. All the patients underwent abdominal radiography. In addition, seven patients underwent an upper gastrointestinal (UGI) contrast study. Four patients developed postoperative complications, and two patients died postoperatively, yielding an overall mortality rate of 3.5%. Conclusions: Until proven otherwise, neonates exhibiting bilious vomiting should be suspected of having malrotation and should receive immediate medical attention. This study found that even with delayed presentation and inadequate facilities, intestinal malrotation had a good prognosis in Sudan.