Midgut nonrotation in adults. An aggressive approach

Area of Science:

• Gastroenterology
• Surgical Anatomy

Background:

• Midgut nonrotation is a congenital anomaly that can persist into adulthood.
• Adult presentation often involves non-specific abdominal symptoms, delaying diagnosis.

Purpose of the Study:

• To review the clinical presentation, diagnosis, and outcomes of adult patients with midgut nonrotation.
• To emphasize the need for aggressive treatment of symptomatic midgut nonrotation.

Main Methods:

• Retrospective review of five adult patients treated for midgut nonrotation.
• Analysis of presenting symptoms, diagnostic imaging (barium enema, upper GI series), and surgical outcomes.

Main Results:

• Patients presented with vague epigastric or lower abdominal pain.
• Diagnosis was often based on left-sided colon on barium enema and duodenal abnormalities on upper GI series.
• Delayed surgical intervention was common due to atypical symptoms and radiographic findings.

Conclusions:

• Midgut nonrotation in adults can lead to significant morbidity, including duodenal ulcer disease and bowel obstruction.
• An aggressive treatment approach is warranted for chronic, recurrent symptoms secondary to midgut nonrotation.
• Symptom resolution is often achieved after anatomic correction.