title: Intestinal volvulus: aetiology, morbidity and mortality in Tunisian children.
abstract: BACKGROUND
  Intestinal volvulus (IV) can occur at various sites of the gastrointestinal tract. In Europe, IV in children is most frequently due to malrotation but in Asia Ascaris infestation is a common cause. This report reviews the experience with IV in children in Tunisia; analyzes the aetiologies as well as the clinical presentations and the benefits of the Ladd's procedure in the treatment of the IV.
  
  
  METHODS
  The authors retrospectively reviewed the case records of all children with IV from January 2000 to December 2009 at the Tunis Children's Hospital.
  
  
  RESULTS
  There were 22 boys and nine girls with an age range of one day to four years. Twenty-five (80%) patients presented during the neonatal period. The most common presentation was bilious vomiting and dehydration. The aetiology was identified in all patients: Anomalies in rotation (n=22), omphalo-mesenteric duct (n=3), internal hernia (n=3), cystic lymphangioma (n=2), caocal volvulus (n=1). The bowel resection rate for gangrene was 16%. All patients with malrotation had Ladd's procedure performed. Five patients (19%) developed wound infections. One patient presented with adhesive small bowel obstruction. There were no recurrences following Ladd's procedure for malrotation. Two neonates (6%) died from overwhelming infections. Intestinal volvulus in our environment differs in aetiology from other reports. The resection rates are not similar, however.
  
  
  CONCLUSIONS
  Early diagnosis reduced the high morbidity and mortality in our study.
authors: Unity of Paediatric Surgery, Tunis Children's Hospital, Tunisia. nouirafaouzi@yahoo.fr
authors: Nouira
authors: N
authors: Faouzi
authors: Ben Ahmed
authors: BA
authors: Yosra
authors: Jlidi
authors: J
authors: Said
authors: Ghorbel
authors: G
authors: Soufiane
authors: Charieg
authors: C
authors: Aouatef
authors: Khemakhem
authors: K
authors: Rachid
authors: Chaouachi
authors: C
authors: Beji
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014416:Tunisia / Q000453:epidemiology