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Malrotation of the intestine is a prevalent birth anomaly, the etiology of which remains poorly understood. Here, we show that late-stage exposure of Xenopus embryos to atrazine, a widely used herbicide that targets electron transport chain (ETC) reactions, elicits intestinal malrotation at high frequency. Interestingly, atrazine specifically inhibits the cellular morphogenetic events required for gut tube elongation, including cell rearrangement, differentiation and proliferation; insufficient gut lengthening consequently reorients the direction of intestine rotation. Transcriptome analyses of atrazine-exposed intestines reveal misexpression of genes associated with glycolysis and oxidative stress, and metabolomics shows that atrazine depletes key glycolytic and tricarboxylic acid cycle metabolites. Moreover, cellular bioenergetics assays indicate that atrazine blocks a crucial developmental transition from glycolytic ATP production toward oxidative phosphorylation. Atrazine-induced defects are phenocopied by rotenone, a known ETC Complex I inhibitor, accompanied by elevated reactive oxygen species, and rescued by antioxidant supplementation, suggesting that malrotation may be at least partly attributable to redox imbalance. These studies reveal roles for metabolism in gut morphogenesis and implicate defective gut tube elongation and/or metabolic perturbations in the etiology of intestinal malrotation.
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http://dx.doi.org/10.1242/dev.202020 | DOI Listing |
J Pediatr Gastroenterol Nutr
September 2025
Robert C. Byrd Health Sciences Center, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA.
Cureus
August 2025
Surgery, AdventHealth Tampa, Tampa, USA.
One of the extremely uncommon manifestations of malrotation is nonrotation, a condition that arises due to the complete failure of the midgut to rotate 270 degrees. The true prevalence in adults remains obscure due to the scarcity of the condition. A standard surgical approach to management is therefore lacking, and an increasing number of case reports is required to establish evidence-based recommendations.
View Article and Find Full Text PDFWorld J Clin Pediatr
September 2025
Department of Pediatric Surgery, American Hospital Dubai, Dubai 440000, Dubayy, United Arab Emirates.
Background: Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow's milk protein allergy (CMPA), complicating diagnosis. This case series highlights 3 pediatric patients initially misdiagnosed with CMPA, emphasizing the need for a thorough evaluation.
Case Summary: Case 1: A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.
Int J Surg Case Rep
August 2025
Department of Internal Medicine, Adera Medical and Surgical Center, Addis Ababa 1000, Ethiopia.
Introduction And Importance: Midgut volvulus is an extremely rare cause of abdominal pain in adults, often due to intestinal malrotation. Its nonspecific and insidious presentation can lead to significant diagnostic delays, increasing the risk of intestinal ischemia, necrosis, or gangrene. Early recognition and prompt surgical intervention are crucial to improving outcomes.
View Article and Find Full Text PDFCureus
July 2025
General Surgery, Hospital General de Occidente, Zapopan, MEX.
Intestinal malrotation is described as an abnormal positioning of intestinal loops within the peritoneal cavity, caused by defective rotation around the superior mesenteric artery. This results in a short mesenteric root, which predisposes to midgut volvulus when the intestine twists on its axis. We present a case of a five-day-old female with bilious vomiting, abdominal distension, and radiographic signs of obstruction.
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