Pediatric emergency medicine trisk 3765 3765

sometimes takes a high position, and this could give a false impression of
malrotation. If an US is obtained, as with possible pyloric stenosis or
intussusception, an abnormal relationship between the superior mesenteric artery
and vein should lead to an upper GI series.
As in the case of a child with an unreduced intussusception, a child with a
possible volvulus should be prepared for immediate surgery. The operating room
and operating team should be notified. IV fluid and electrolyte replacement
should begin immediately. Laboratory studies should be obtained, but they do not
add to the diagnostic evaluation. A nasogastric tube should be inserted and blood
cross-matched. Because this entity can present even in adulthood, every physician
should understand the pathogenesis and the need for emergency surgical
treatment of volvulus. If immediate transfer to a pediatric hospital cannot be
accomplished within an hour, a laparotomy should be performed without delay.