Any blockage of the digestive tract that prevents the proper passage of food is known as an intestinal obstruction. Some causes of intestinal obstruction include a congenital (present at birth) malformation of the digestive tract, hernias, abnormal scar tissue growth after an abdominal operation, and inflammatory bowel disease. These blockages are also called mechanical obstructions because they physically block a portion of the intestine or another part of the digestive tract.

Malrotation is a type of mechanical obstruction caused by abnormal development of the intestines while a fetus is in the mother's womb. It occurs in one out of every 500 births in the United States and accounts for approximately 5% of all intestinal obstructions. Some children with malrotation have other congenital malformations including:

• defects of the digestive system
• heart defects
• abnormalities of other organs, including the spleen or liver

Some people who have malrotation never experience complications and are never diagnosed. But most children with this condition develop symptoms during infancy, often during the first month of life, and the majority are diagnosed by the time they reach 1 year of age. Although surgery is required to repair malrotation, most children experience normal growth and development once the condition and any problems associated with it are treated and corrected.

What Is Malrotation?
The small and large intestines are the longest part of the digestive system. If stretched out to their full length, they would measure more than 20 feet long by adulthood, but because they are coiled up, they fit into the relatively small space of the abdominal cavity. Malrotation occurs when the intestines don't "coil" properly during fetal development. The exact cause is unknown.

When a fetus is developing in the womb, the intestines start out as a small, straight tube between the stomach and the rectum. As this tube develops into separate organs, the intestines move for a time into the umbilical cord, which supplies nutrients to the developing embryo.

Around the tenth week of pregnancy, the intestine moves from the umbilical cord into the abdomen. It fits in by making two turns that allow it to lie in a specific position within the abdomen. When the intestine does not make these turns properly, malrotation has occurred.

Malrotation in itself may not cause any problems. However, it may be accompanied by additional complications:

• Bands of tissue called Ladd bands may form, obstructing the first part of the small intestine (the duodenum).
• After birth, volvulus may occur. This is when the intestine twists on itself, causing a lack of blood flow to the tissue and leading to tissue death. Malrotation is often diagnosed when volvulus occurs, frequently during the first weeks of life.

Obstruction caused by volvulus or Ladd bands are both life-threatening problems. The intestines can stop functioning and intestinal tissue can die from lack of blood supply if an obstruction isn't recognized and treated.

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