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© 2018 Elsevier Inc. Introduction: Isomerism, or heterotaxy syndrome, affects many organ systems anatomically and functionally. Intestinal malrotation is common in patients with isomerism. Despite a low reported risk of volvulus, some physicians perform routine screening and prophylactic Ladd procedures on asymptomatic patients with isomerism who are found to have intestinal malrotation. The primary aim of this study was to determine if isomerism is an independent risk factor for volvulus. Methods: Kid's Inpatient Database data from 1997 to 2012 was utilized for this study. Characteristics of admissions with and without isomerism were compared with a particular focus on intestinal malrotation, volvulus, and Ladd procedure. A logistic regression was conducted to determine independent risk factors for volvulus with respect to isomerism. Results: 15,962,403 inpatient admissions were included in the analysis, of which 7970 (0.05%) patients had isomerism, and 6 patients (0.1%) developed volvulus. Isomerism was associated with a 52-fold increase in the odds of intestinal malrotation by univariate analysis. Of 251 with isomerism and intestinal malrotation, only 2.4% experienced volvulus. Logistic regression demonstrated that isomerism was not an independent risk factor for volvulus. Conclusion: Isomerism is associated with an increased risk of intestinal malrotation but is not an independent risk factor for volvulus. Type of Study: Prognosis study. Level of Evidence: Level III.
Author(s): Landisch RM, Loomba RS, Salazar JH, Buelow MW, Frommelt M, Anderson RH, Wagner AJ
Publication type: Article
Publication status: Published
Journal: Journal of Pediatric Surgery
Year: 2018
Volume: 53
Issue: 6
Pages: 1118-1122
Print publication date: 01/06/2018
Online publication date: 06/03/2018
Acceptance date: 27/02/2018
ISSN (print): 0022-3468
ISSN (electronic): 1531-5037
Publisher: WB Saunders Co.
URL: https://doi.org/10.1016/j.jpedsurg.2018.02.071
DOI: 10.1016/j.jpedsurg.2018.02.071
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