Advances in Pediatric Surgery

[English]

Perception on the Intestinal Malrotation: A 2021 Survey Conducted by the Korean Association of Pediatric Surgeons: Hee-Beom Yang, Min Jeng Cho, Yu Jeong Cho, Yoon Mi Choi, Jae Hee Chung, Seok Joo Han, Jeong Hong, Eunyoung Jung, Ki Hoon Kim, Soo-Hong Kim, Cheol-Gu Lee, Nam-Hyuk Lee, Ju Yeon Lee, Sanghoon Lee, Suk Bae Moon, Young-Hyun Na, So Hyun Nam, Chaeyoun Oh, Jin Young Park, Junbeom Park, Tae-Jin Park, Jae Ho Shin, Joonhyuk Son, Hyun-Young Kim, The Korean Association of Pediatric Surgeons; Adv Pediatr Surg 2025;31(2):59-65. Published online August 5, 2025; DOI: https://doi.org/10.13029/aps.2025.31.2.59

Abstract
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Purpose
To report the findings of a perception survey on intestinal malrotation conducted by the Korean Association of Pediatric Surgeons (KAPS) in 2021.
Methods
The perceptions on intestinal malrotation regarding clinical decision making of the KAPS members were collected through web-based survey.
Results
A total of 22 surgeons were answered for this study. The results were presented and discussed at the 37th annual meeting of KAPS, which was held in Seoul on June 18, 2021.
Conclusion
This study provides the clinical decisions of the KAPS members on the intestinal malrotation. The study is expected to be an important reference for improving pediatric surgeons’ understanding and treatment of intestinal malrotation.

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[English]

Transverse Colon Volvulus around the Gastrostomy Tube in a Pediatric Situs Inversus Patient: Yoon Hyung Kang, Joong Kee Youn, Ji-Won Han, Chaeyoun Oh, Sung-Eun Jung, Hyun-Young Kim; J Korean Assoc Pediatr Surg 2018;24(1):26-29. Published online June 30, 2018; DOI: https://doi.org/10.13029/jkaps.2018.24.1.26

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An 18-year-old male patient with cerebral palsy and scoliokyphosis came to the emergency department with abdominal distension and vomiting. He was a situs inversus patient with a feeding gastrostomy tube. Sigmoid volvulus was initially suspected, so rectal tube insertion and endoscopic decompression were attempted, but failed. So he went through explorative laparotomy, and transverse colonic adhesion and twisting around the gastrostomy tube and gastric wall was identified. Adhesiolysis and resection with redundant transverse colon and end-to-end colocolic anastomosis was performed. He discharged with symptom free. Suspecting transverse colonic volvulus is important when the patient has anatomical anomalies and feeding gastrostomy tube. Timely diagnosis with proper radiologic imaging should be made. Surgical resection of the redundant colon is needed for successful management of transverse colonic volvulus.

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[English]

Ileal Duplication in a Neonate With Jejuno-Ileal Atresia, Midgut Malrotation and Volvulus: Dudhani, Shreyas , Suman, Bijay , Singh, Ramjeewan , Sinha, Amit Kumar , Kumar, Bindey; Adv Pediatr Surg 2023;29(1):40-44.; DOI: https://doi.org/10.13029/aps.2023.29.1.40

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Jejuno-ileal atresia is often associated with various other gut pathologies. A 5-day male presented with bilious vomiting, abdominal distension and non-passage of stools. Exploratory Laparotomy showed a type IIIA ileal atresia with midgut volvulus and atypical malrotation for which Ladd’s Procedure and anastomosis of atretic bowel was done. A fleshy tubular structure extracted from distal bowel showed ileal duplication. In JIA, the vascular theory of pathogenesis is widely accepted with multiple studies to suggest the same. The mechanism being mesenteric ischemia leading to intestinal necrosis, resorption, and atresia. It has been found that abdominal duplication cyst often occurs simultaneously with short bowel, intestinal atresia, stenosis and enteric duplication for which a common vascular pathogenetic mechanism has been suggested. Our case serves as an in vivo description of the proposed theory where the findings may be described elegantly. We describe and discuss the mesenteric ischemia theory in bowel atresia and hope to further our understanding about the same.

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[English]

Recurrent Attacks of Sigmoid Volvulus in a 16-Year-Old Boy: A Case Report: Choi, So Yoon , Kim, Ki Hoon; Adv Pediatr Surg 2020;26(1):28-32.; DOI: https://doi.org/10.13029/aps.2020.26.1.28

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Sigmoid volvulus (SV) occurs due to the twist of a dilated sigmoid colon on its mesenteric axis, which can compromise the blood supply to the colon, leading to necrosis or perforation of the sigmoid colon. Potentially life threatening, SV is common in the elderly and rare in youth. We present the case of a 16-year-old boy who had experienced 3 episodes of SV over the course of a year and was successfully treated with laparoscopic-assisted sigmoid colectomy. SV should be considered when a young patient has a history of recurrent abdominal pain, constipation, and abdominal distension.