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[Congenite intestinal malrotation as cause of intermittent abdominal pain]

Poul Edling1, Anders Tøttrup

  • 1Hans Schourupsgade 9, 5. tv., 8000 Aarhus C. poul.edling@gmail.com.

Ugeskrift for Laeger
|December 16, 2014
PubMed

Insights

Intestinal malrotation, a congenital condition, can manifest in adulthood causing severe abdominal pain. A 49-year-old woman

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Paediatric Surgery in Adults

Background:

  • Intestinal malrotation is a congenital anomaly of midgut rotation and fixation during fetal development.
  • While typically diagnosed in infancy, it can present symptomatically in adulthood, leading to complications like volvulus and obstruction.
  • Adult-onset intestinal malrotation often presents with chronic or acute abdominal pain.

Observation:

  • A 49-year-old female presented with a history of chronic, intermittent abdominal pain.
  • Severe acute abdominal pain prompted hospital admission and diagnostic imaging.
  • Computed tomography revealed a displaced cecum and the characteristic mesenteric whirlpool sign.

Findings:

  • The patient was diagnosed with intestinal malrotation, a condition usually seen in pediatric patients.
  • Surgical intervention was deemed necessary due to the symptomatic presentation.
  • A laparoscopic Ladd's procedure was successfully performed.

Implications:

  • This case underscores the importance of considering intestinal malrotation in adult patients with chronic or acute abdominal symptoms.
  • Laparoscopic Ladd's procedure offers a minimally invasive approach for treating adult intestinal malrotation.
  • Early diagnosis and surgical management can prevent severe complications like bowel ischemia.

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