[Intestinal obstruction for malrotation in an adult patient. Report of a case]

We present a case of a 78 year-old man with the pathological antecedent of chronic constipation that comes to our emergency room at the Victor Lazarte Echegaray Hospital. He presented abdominal pain and progressive abdominal distension, nausea and bilious vomits of two days of evolution. The clinical examination showed an evident abdominal distension, and some metallic intestinal noises. A frontal and lateral simple abdominal x- ray showed a considerable distension of the gastric camera and intestinal loops and free fluid all over the abdominal cavity, all of which was compatible with the diagnosis of intestinal obstruction. At the operating room we proceeded with a exploration and we founded an intestinal obstruction at the ascending colon (Ladd's Bands) of high location with bloody fluid in the abdominal cavity, multiple fecalomas in the descending colon, and intestinal ischemia in the distal small bowel, the color, tone and coiling of the intestine recovered after section of the Ladd's bands. The patient evolved favorably.