Chronic diarrhea and failure to thrive as rare manifestations of intestinal malrotation in infancy: a case report and systematic review of the literature

Diarrhea is a common symptom in pediatrics and can lead to severe complications such as dehydration and even death. While most cases are caused by infections or milk intolerance, diarrhea can also be linked to more serious underlying conditions.

A systematic review of all reported cases of pediatric intestinal malrotation was conducted. Information related to clinical presentation, examination, workup, operative findings, management, and outcome was systematically recorded.

We report a case of an infant, aged 6.5 months, who presented with chronic diarrhea, bilious vomiting, and failure to thrive. The patient’s history included a history of frequent infections and familial cases of metabolic disease. Further diagnostic workup, including an upper gastrointestinal series, revealed intestinal malrotation. The patient underwent a Ladd’s procedure, with subsequent improvement in her symptoms and normalization of growth on follow-up.

We identified 37 case reports; most were male, and most common presenting symptom was vomiting (54%), while diarrhea was reported in 10.8% of cases.

This case highlights the importance of considering intestinal malrotation in the differential diagnosis of chronic diarrhea in infants. Early diagnosis and intervention can significantly improve patient outcomes.