What is malrotation?

Malrotation is an abnormality in which the intestine does not form in the correct way in the abdomen. It occurs early in the pregnancy (around the 10th week) and develops when the intestine fails to coil into the proper position in the abdomen. Malrotation is often not evident until the baby experiences a twisting of the intestine known as a volvulus. A volvulus is a disorder that causes an obstruction in the intestine, preventing food from being digested normally. The blood supply to the twisted part of the intestine can also be cut off, leading to the death of that segment of the intestine. This situation can become fatal if not treated as soon as possible.

Malrotation occurs in one out of every 500 births in the United States. Among those children who have malrotation and develop symptoms, most symptoms will occur in the first year of life. Nearly 60% of cases are diagnosed during the first week of life. Malrotation occurs equally in boys and girls. However, more boys show symptoms within the first month of life than girls.

What causes malrotation?

The exact cause of malrotation is unknown.

What are the symptoms of malrotation?

One of the earliest signs of malrotation is abdominal pain and cramping caused by the inability of the bowel to push food past the obstruction. A baby with cramps and pain due to malrotation frequently follows a typical pattern where he or she will begin crying while pulling his or her legs up, stop crying suddenly, act normal for a 10 or 15 minutes, then begin crying suddenly again, starting the pattern all over.

Other symptoms of malrotation may include:

  • Frequent vomiting, often green or yellow-green in color
  • A swollen, firm abdomen
  • Pale color
  • Poor appetite
  • Little or no urine (due to fluid loss)
  • Infrequent bowel movements
  • Blood in the stools
  • Fever
  • Lethargy (showing little energy)