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[Adult intestinal no rotation]

Hugo Daniel Ruiz, Fernando Álvarez, Ignacio Solari

    Acta Gastroenterologica Latinoamericana
    |July 14, 2017
    PubMed

    Insights

    Intestinal malrotation, typically seen in infants, can cause intestinal obstruction in adults. This case highlights a rare adult presentation of malrotation, successfully treated with Ladd's procedure.

    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.

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