Adult Malrotation With Midgut Volvulus: A Case Requiring Temporary Abdominal Closure and Second-Look Operation

Malrotation is a rotational anomaly of the embryonic bowel, which can be complicated by midgut volvulus. This phenomenon is typically seen in the pediatric population. Presentation in adults is rare and can present diagnostic challenges that delay diagnosis and time from presentation to definitive management in the operating room. In this case, a 43-year-old female with a past medical history of anxiety and no prior abdominal surgery presented to the emergency department with four days of abdominal pain and obstipation. She was ultimately determined to have malrotation with midgut volvulus based on intraoperative findings. There are other case reports involving adult malrotation in the current body of literature. This case is unique as the patient presented with necrotic small bowel requiring resection, temporary abdominal closure, and a second-look operation to evaluate intestinal viability and restore continuity of the bowel.