Type 3B Malrotation Presented with Acute Appendicitis as Left Renal Colic

Area of Science:

• Pediatric Surgery
• Developmental Biology
• Gastrointestinal Surgery

Background:

• Midgut malrotation is a congenital anomaly resulting from incomplete embryonic rotation of the midgut.
• It presents diagnostic challenges, particularly in cases of acute abdominal pain.
• Understanding its embryological basis is crucial for diagnosis and management.

Observation:

• A rare form of midgut malrotation (nonrotation of the proximal loop with partial rotation of the distal loop) was identified.
• The patient presented with symptoms suggestive of acute abdominal pain.
• Ruptured appendicitis was diagnosed in conjunction with the malrotation anomaly.

Findings:

• The rare malrotation subtype complicated the presentation of appendicitis.
• Appendicitis occurred on the left side due to the abnormal positioning of the midgut.
• This case underscores the importance of considering atypical presentations of appendicitis.

Implications:

• Left-sided acute appendicitis should be included in the differential diagnosis for patients with left lower quadrant pain.
• This case highlights the diagnostic complexity of midgut malrotation with associated pathologies.
• Accurate diagnosis and timely intervention are critical for managing such rare congenital anomalies.