Congenital midgut reverse transposition with herniation of the jejunum into a malformed omentum: A case report

Congenital malrotation of the intestine is characterized by an abnormality in intestinal anatomy and mesenteric fixation resulting from disordered rotation of the intestine around the mesenteric artery during embryonic life. This disease can cause intestinal torsion, intestinal obstruction and other acute abdominal symptoms.

A 23-year-old female patient was admitted to our hospital on January 11, 2024, with a history of recurrent periumbilical pain for over 10 years and worsening for 6 months. In this report, the patient was diagnosed with a congenital midgut malrotation with herniation of the jejunum into a malformed omentum in surgery. The patient developed a hernia sac of the omentum adjacent to the duodenum, with the upper jejunum herniating to form an intra-abdominal hernia. During surgery, the jejunum-ileum and ileocecal junction were positioned according to their normal anatomy, and the mesentery root was linearly fixed to the posterior abdominal wall. Ascending colon and right transverse colon were repositioned in their normal anatomical locations. The patient was monitored for more than 1 year post-surgery and recovered well with no signs of abdominal pain or distension.

Congenital midgut reverse transposition is a specific malrotation of the intestine that is often found in adulthood. It is prone to forming intra-abdominal epiploic hernias. Personalized surgical treatment can achieve better results.