Partial Malrotation of Bowel Loops in an Adolescent with Left Hypochondrial Pain

In the embroyological development, any deviation from physiological midgutrotation results in intestinal malrotation, which may further cause midgutvolulus or intestinal obstruction. It is predominantly a pediatric diagnosis; however, it may occur in adolescent or adult life. A case is presented here of a 17-year boy who came in Accident and Emergency Department, Abbasi Shaheed Hospital with complaint of intermittent and severe intensity pain in left upper quadrant of abdomen. Screening ultrasound abdomen was done, which was unremarkable; then he underwent Doppler evaluation of upper abdomen. Doppler ultrasound depicted abnormal vertical orientation of superior mesenteric vessels. He underwent barium enema, which revealed features of intestinal malrotation. He was further investigated with contrast-enhanced CT abdomen for complications, which confirmed the aforementioned abnormal orientation of superior mesenteric vessels and diagnosis of intestinal malrotation without any complication. In summary, any non-specific abdominal complaint with or without intestinal obstruction in an adolescent or adult patient should be investigated for the possibility of intestinal malrotation.