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Updated: Aug 7, 2025

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Published on: August 11, 2023
Emergent initial presentation of congenital malrotation with midgut volvulus in 68-year-old
Maria E Tecos1, Margarita Pipinos1, Brett H Waibel1
1Department of General Surgery, University Of Nebraska Medical Center, Omaha, NA 68198, USA.
Insights
Congenital malrotation, a condition usually seen in infants, can rarely occur in adults. This case highlights a 68-year-old woman with unexpected midgut volvulus due to malrotation, emphasizing the need for thorough evaluation in atypical presentations.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Pathology
Background:
- Congenital malrotation is a rare condition typically diagnosed in infants.
- Adult diagnosis of malrotation often involves a history of chronic gastrointestinal issues.
- Atypical presentations in adults can lead to diagnostic delays and suboptimal care.
Abstract:
Congenital malrotation is a pathology nearly exclusive to the infant population. In the rare instance when it is diagnosed in an adult, it is typically associated with a longstanding history of gastrointestinal symptoms. Unfortunately, this unique presentation in an unexpected population has the potential to be confounding, leading to delayed or mismanaged care. Here, we describe an intriguing case of congenital malrotation complicated by midgut volvulus in a 68-year-old woman. Even more curious, the patient did not have a medical history plagued by abdominal complaints. Careful, comprehensive evaluation yielded appropriate surgical management via Ladd's procedure and right hemicolectomy in this complex patient.
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