INTESTINAL MALROTATION IN PATIENTS UNDERGOING BARIATRIC SURGERY.

Autor:	Vidal EA; Department of General Surgery, Hospital Clínica Alcívar, Guayaquil, Ecuador;, Rendon FA; Department of General Surgery, Hospital Clínica Alcívar, Guayaquil, Ecuador;, Zambrano TA; Department of General Surgery, Hospital Clínica Alcívar, Guayaquil, Ecuador;, García YA; Department of General Surgery, Hospital Clínica Alcívar, Guayaquil, Ecuador;, Viteri MF; Department of General Surgery, Hospital Clínica Alcívar, Guayaquil, Ecuador;, Campos JM; Federal University of Pernambuco, Recife, Brazil;, Ramos MG; Gastro-Obeso-Center Advanced Surgical Institute, São Paulo, Brazil., Ramos AC; Gastro-Obeso-Center Advanced Surgical Institute, São Paulo, Brazil.
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery [Arq Bras Cir Dig] 2016; Vol. 29Suppl 1 (Suppl 1), pp. 24-26.
DOI:	10.1590/0102-6720201600S10007
Abstrakt:	Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Results: Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Conclusion: Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach. Competing Interests: none
Databáze:	MEDLINE
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