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A malrotation has no symptoms until a volvulus occurs. Then, like a strangler, it can act quickly.
If the volvulus becomes tight enough, the blood supply to the intestines will be cut off in the same way the flow of water to a sprinkler becomes interrupted if the hose becomes kinked. The intestines can only live for a matter of hours without a blood supply.
If a patient has the symptoms of a volvulus, immediate, emergency surgery is necessary. A wait-and-see approach is unacceptable. Although the volvulus may unwrap on its own, it is also possible the intestines will die. Generally, by the time there are signs of intestine death (like infection), it is too late.
The symptoms of a volvulus include vomiting and gut-wrenching pain. The vomit may be stained with bile (green or yellow) because the bile fluids that help digest food continue to pour into the intestines, but can’t get past the blockage and come up as the pressure builds. In a newborn, green vomit is a medical emergency until proven otherwise.
Once a volvulus is suspected, an upper GI can confirm the diagnosis. The test requires the patient to drink a dye that can be seen on x-ray and the fluid is watched as it progresses. Malrotation, one of the causes of volvulus, can be seen on an upper GI.
Malrotations are found most often in newborns, but can escape diagnosis in some cases into childhood, and in rare cases, it will not be found until a person is an adult. The frequency of the condition is not well known, but is suspected to affect as many as 1 in every 2,000 children.
- Was there undue delay by the physicians and nurses involved in the patient’s care before properly responding in a prompt and timely manner to the patient’s signs and symptoms?
- Even if there was an undue delay, did it make a difference in the outcome?
Standard of Care
For a pediatrician or surgeon, green vomit in a newborn should be presumed to be an emergency until proven otherwise. Hours count, and a wait and see attitude is not acceptable. Like a heart attack, the condition may clear up on its own, but it may not. Medical treatment should not wait.
- Malrotation: A congenital failure of the intestines to rotate to their normal position during fetal development causing the possibility of a volvulus after birth.
- Volvulus: The twisting of the bowels causing the risk of killing some or all of the intestines, because the main supply of blood gets choked off if the twisting gets too tight.
- Intestines: The organ of the body responsible for digestion. If a small portion dies, surgical repair allows for a relatively normal life. If all of the intestines are killed, then the patient will need intravenous feeding, which generally leads to other complications and is still an unsuccessful long-term solution. Intestine transplants are only done at a few centers around the country and are generally unsuccessful.
Seeking Legal Advice
GorenLaw has years of experience dealing with medical malpractice issues, and has recovered substantial amounts of money for people whose doctors failed to treat symptoms of malrotation properly.
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