title: [Bilious vomiting due to malrotation, also in older children].
abstract: Three children presented with bilious vomiting due to malrotation at the age of 3, 5 and 12 years, respectively. They were treated surgically and recovered fully. In the period 1989-2002, 12 patients were operated for malrotation after the first year of life in the Emma Children's Hospital AMC, Amsterdam, the Netherlands. The mean age at operation was 5 years (range: 1-15). The most important symptoms were (bilious) vomiting and abdominal pain. Four patients had a history of bilious vomiting in the neonatal period. Nine patients had been previously admitted to a hospital with abdominal complaints. The most sensitive imaging technique was an upper gastrointestinal contrast study. Malrotation with intermittent volvulus can cause recurrent abdominal complaints and vomiting in children. Bilious vomiting is pathologic at any age and should lead to further investigations, preferably an upper gastrointestinal contrast study to exclude malrotation or other obstructions.
authors.affiliation: Kinderchirurgisch Centrum Amsterdam/Universiteit van Amsterdam, locatie Emma Kinderziekenhuis AMC, Postbus 22.660, 1100 DD Amsterdam.
authors.forename: M
authors.initials: M
authors.lastname: Bruijn
authors.forename: B H
authors.initials: BH
authors.lastname: Wolf
authors.forename: A M
authors.initials: AM
authors.lastname: Smets
authors.forename: H A
authors.initials: HA
authors.lastname: Heij
authors.forename: D C
authors.initials: DC
authors.lastname: Aronson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001646:Bile; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D045822:Intestinal Volvulus / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D008297:Male; D011379:Prognosis; D014839:Vomiting / Q000209:etiology*