The bowel will be detorsed (unwound) and checked carefully (see pictures). The bowel that turns pink (showing returned circulation) after torsion is good bowel. If all bowel turns pink, a Ladd’s procedure will be performed to put the bowel in place to prevent another volvulus. An is usually done since the appendix will not be located in the normal area in the abdomen. This could lead to confusion and delay in diagnosing appendicitis in the future.
If there is a question about the bowel’s viability, the abdomen will be left open and a second-look procedure will be planned within 24 to 48 hours.
If there is a section of necrotic (dead) bowel a colostomy may be needed temporarily. The nurse will consult with you on ostomy care.
|The operation done to repair malrotation is called Ladd’s procedure. In Ladd’s procedure, the abdomen is opened (Diagram A).
The small intestines are seen first and appear to hide the colon. The entire intestinal mass is delivered out of the abdomen (Diagram B).
The intestinal mass is rotated to reduce the volvulus (Diagram C).
The intestines are re-positioned in the abdomen (Diagram D).
Diagram E shows the appearance of the intestines at the end of surgery
This exam requires the use of a radiopharmaceutical mixed with milk, breast milk, or formula that your child will drink.
What should you expect during the exam?
The technologist will ask why the Milk Scan is being done, and explain the study to you and your child. We will then place a small amount of radioactive material into the milk/breast milk/formula that you bring from home. There are no side effects and the medicine will not change the taste of the milk/breast milk/formula. Your child will then drink their milk/breast milk/formula. Your child will need to drink two to eight ounces, depending on their ability, in ten minutes. We will work with you if your child has special needs.
The scan will begin while your child is swallowing and will continue for approximately one hour. Your child will lay on their back, on our table, with the camera underneath them.
If your child has a history of problems with swallowing, a special tube called an NG tube (nasogastric) will be inserted prior to the study by a Radiology Nurse. The tube is inserted through the nose and ends in the stomach. The liquid will be injected through the tube for the exam.
We do not sedate for this procedure.