Intestinal Malrotation In The Older Child: Common Diagnostic Pitfalls.

8 children aged 4 to 14yrs (mean age 9yrs) with a clinical diagnosis of intestinal malrotation were studied prospectively over a 4yr period at the University of Nigeria Teaching Hospital Enugu. Despite, the reported normal barium studies of the uppergastrointestinal tract in the children, surgery were done based on strong clinical suspicion, chronic morbidity, and our interpretation of the barium studies. Operative findings were consistent with intestinal malrotation. 7 patients were symptom-free after 3months to 3yrs follow-up. One patient died of gastroenteritis 2 weeks post-operatively. A high index of suspicion and a close co-operation between Radiologists and Paediatric Surgeons are required for prompt and accurate diagnosis of intestinal malrotation in the older child.