Intestinal malrotation during pregnancy

Malrotation of the intestine is an uncommon anomaly most often seen in infants, but occasionally in adults. Rarely, symptoms from malrotation may occur during pregnancy.

A 30-year-old woman, with a long history of abdominal pain and constipation, developed more frequent and severe symptoms in the second trimester of pregnancy. She was monitored closely and treated conservatively and went on to deliver a full-term, healthy infant. In the postpartum period, barium radiographs demonstrated a midgut malrotation. During exploratory laparotomy, obstructive peritoneal bands were noted and were transected. The mobile cecum and ascending colon were fixated to the abdominal wall.

Symptoms from a malrotation may develop during pregnancy and may be nonspecific and vague. Although complications from malrotation can be life-threatening, a conservative approach with surgical intervention in the postpartum period may be appropriate in the proper clinical setting.