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Midgut Volvulus Preop — RACP Paediatrics MCQ

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HardGastroenterologyMidgut Volvulus PreopRACP Paediatrics

A 6-year-old presents with an acute abdomen. CT shows a malrotation with midgut volvulus. Alongside urgent surgery, what preoperative step is essential?

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Correct answer: E — Aggressive IV fluid resuscitation and broad-spectrum antibiotics

Midgut volvulus is a surgical emergency. Preoperative management includes aggressive IV fluid resuscitation (the bowel may be ischaemic/necrotic causing third-space losses and sepsis), broad-spectrum antibiotics, nasogastric decompression, and urgent Ladd procedure. Time to surgery directly correlates with bowel viability.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Malrotation with Volvulus