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Midgut malrotation: a rare presentation of bowel obstruction in the adult

Ulanda Singh1, Akil Baker2

  • 1Department of Surgery, University Hospital of the West Indies, Mona, Jamaica.

Journal of Surgical Case Reports
|July 28, 2021
PubMed

Insights

Intestinal malrotation, a congenital condition, can cause delayed diagnosis due to non-specific symptoms. This case highlights a 59-year-old male with midgut malrotation presenting as small bowel obstruction from Ladd bands.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Congenital Abnormalities

Background:

  • Intestinal malrotation is a rare congenital anomaly.
  • Presentation typically occurs in infancy, but delayed diagnosis in adulthood is possible due to non-specific gastrointestinal symptoms.
  • Complications include adhesive bowel obstruction and volvulus.

Observation:

  • A 59-year-old male presented with a large, incarcerated right inguinoscrotal hernia.
  • Emergency laparotomy revealed midgut malrotation and small bowel obstruction.
  • Ladd bands were identified as the cause of obstruction.

Findings:

  • The patient had undiagnosed intestinal malrotation presenting in adulthood.
  • Small bowel obstruction was caused by adhesive bands (Ladd bands) associated with malrotation.
  • Surgical intervention included a modified Ladd's procedure and herniorrhaphy.

Implications:

  • This case underscores that intestinal malrotation can manifest in adulthood.
  • Prompt surgical management is crucial for complications like bowel obstruction.
  • Awareness of malrotation in adults is important for timely diagnosis and treatment.

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