Intestinal Malrotation and Midgut Volvulus With Intussusception: An Unusual Association

To the Editor.—Intestinal malrotation with midgut volvulus is an important surgical emergency in pediatric practice. Successful outcome of this clinical condition depends on prompt diagnosis and timely surgical intervention. Delay in diagnosis can lead to an increase in mortality and morbidity. Malrotation volvulus is associated with other anomalies of the gastrointestinal tract in 15% to 31% of cases,^1-3 but its association with intussusception is very rare. Two such cases of malrotation volvulus associated with intussusception are reported herein, and the literature is reviewed briefly.

Report of Cases.—Case 1.—An 8-month-old girl presented with a two-day history of bloody diarrhea, irritability, and green vomiting. Examination of the abdomen disclosed a mobile tender mass in the left iliac fossa with exaggerated bowel sounds but no distention. A rectal examination disclosed bright red blood. A plain abdominal roentgenogram demonstrated a dilated stomach and duodenal loop with a paucity of gas