[Adult intestinal no rotation]

Area of Science:

• Gastroenterology
• Surgical Innovation
• Pediatric Surgery

Background:

• Intestinal malrotation is a congenital anomaly where intestines fail to rotate properly during fetal development.
• It predominantly affects infants, with 90% of intestinal obstruction cases occurring before one year of age.
• Adult presentations of intestinal malrotation leading to obstruction are exceedingly rare.

Observation:

• A 27-year-old female presented with severe abdominal pain, vomiting, distention, dehydration, and malnutrition.
• Initial management included esophagogastroduodenoscopy (EGDS) and CT scan, followed by a 48-hour clinical observation period.
• Surgical intervention was deemed necessary due to a diagnosis of high intestinal obstruction.

Findings:

• Intraoperative findings revealed a complete absence of intestinal rotation, confirming intestinal malrotation.
• The patient underwent Ladd's procedure, a surgical technique to correct intestinal malrotation.
• A prophylactic appendectomy was also performed during the surgery.

Implications:

• This case underscores the importance of considering intestinal malrotation in adult patients presenting with symptoms of high intestinal obstruction.
• Successful surgical management with Ladd's technique in this adult patient demonstrates its efficacy beyond pediatric cases.
• The rarity of this condition in adults warrants increased awareness among clinicians for timely diagnosis and intervention.