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True versus Pseudo-Intestinal Malrotation: Case Series and Review.
Harshit S Khara1, Shivangi T Kothari2, Claudia B Gruss3
1Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE.
ACG Case Reports Journal
|July 10, 2015
Summary
Intestinal malrotation, a rare adult diagnosis, requires careful differentiation from pseudo-malrotation. Recognizing these conditions is crucial for appropriate surgical or non-surgical management in adults.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Radiology
Background:
- Intestinal malrotation is a congenital anomaly of fetal intestinal rotation.
- It typically presents in infancy or early childhood but is rarely diagnosed in adults.
- Symptomatic presentations in adults often necessitate surgical intervention.
Observation:
- Two adult cases with radiological diagnosis of intestinal malrotation are presented.
- Case 1: True malrotation presenting as a duodenal mass.
- Case 2: "Pseudo-malrotation" due to altered anatomy.
Findings:
- Differentiating true malrotation from pseudo-malrotation in adults is critical.
- Misdiagnosis can lead to inappropriate management strategies.
- Radiological assessment plays a key role in diagnosis.
Implications:
- Highlights the importance of considering intestinal malrotation in adult patients with relevant symptoms.
- Emphasizes the need for accurate radiological interpretation to guide acute management.
- Underscores the distinct treatment pathways for true versus pseudo-malrotation in adults.
