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TÜRKÇE
Poster Display - 59
Congenital volvulus and Ladd's syndrome in neonates and infants - Ten-year experience of our department
Eliska Pajerova, Dagmar Sovadinova, Vojtech Dotlacil, Jiri Snajdauf, Michal Rygl
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
Introduction
Congenital volvulus and Ladd’s syndrome are types of intestinal malrotation presenting in neonates and infants with vomiting and abdominal distension. Without prompt diagnosis and surgery, they may lead to ischemia, short bowel syndrome or death. This study evaluates diagnostics, surgical treatment and complications in patients treated over the past ten years.
Methods
This retrospective single-center study analyzes patients who underwent surgery for congenital volvulus or Ladd’s syndrome between January 2015 and December 2024. The assessed parameters included demographic data, clinical presentation, diagnostic methods, type of surgical intervention, and postoperative complications classified according to the Clavien-Dindo classification (CD).
Results
A total of 38 patients were included (42.1% female). The median gestational age was 38+4 (IQR 36+4-39+4),weeks, birth weight 3062g (IQR 2657,5-3642,5), and age at first surgery 6 days (IQR 3-15,5). Ultrasound was performed in 94.7%, with a positive whirlpool sign in 58.3%. Bowel resection due to necrosis was necessary in 9 patients (23.7%); 5 had primary anastomosis and 4 received a stoma. Ladd’s procedure was performed in 29 patients (76.3%), with 4 second-look surgeries. Clavien-Dindo grade III complications occurred in 13.2%, mostly after resection. One patient (2.6%) developed short bowel syndrome and one (2.6%) died from extensive necrosis and multiorgan failure. Median follow-up was 30 months (IQR 11-75).
Conclusion
Prompt diagnosis and surgery are key to a favorable outcome in congenital volvulus and Ladd’s syndrome. In our series, the diagnostically significant whirlpool sign was identified in only 58% of cases. When volvulus cannot be reliably excluded, surgery should be performed without delay.