Left-sided cecal diverticulitis associated with midgut malrotation

Area of Science:

• Gastroenterology
• Surgical Pathology
• Pediatric Surgery

Background:

• Midgut malrotation is predominantly a pediatric condition, rarely diagnosed in adults.
• Delayed diagnosis in adults can lead to complex presentations and treatment challenges.
• An elevated index of suspicion is crucial for identifying malrotation in adult patients with abdominal complaints.

Observation:

• A 26-year-old male presented with left lower abdominal pain.
• Preoperative CT suggested left-sided appendicitis, but intraoperative findings revealed ruptured cecal diverticulitis with abscess.
• The patient had abnormally located abdominal organs consistent with midgut malrotation.

Findings:

• Ruptured cecal diverticulitis with abscess formation was confirmed during laparotomy.
• The patient underwent cecectomy and experienced a complicated postoperative recovery.
• The case underscores the diagnostic rarity and potential for misdiagnosis of midgut malrotation in adults.

Implications:

• This case highlights the importance of considering malrotation in adult abdominal emergencies, even when symptoms mimic common pediatric conditions.
• Surgical management of adult midgut malrotation, particularly with concurrent pathologies like diverticulitis, remains a subject of debate.
• Further research into the surgical strategies for adult midgut malrotation is warranted to improve patient outcomes.