An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult
Year 2025,
Volume: 42 Issue: 1, 92 - 94, 28.03.2025
Ömer Jaradat
,
Zamir Kemal Ertürk
,
Burak Şahin
Abstract
Intestinal malrotation is a rare congenital abnormality that typically presents in the neonatal period or within the first year of life. However, it is exceedingly rare for this condition to persist without symptoms or go undiagnosed until adulthood. Case Report: A 70-year-old man sought medical assistance due to severe abdominal pain, nausea, vomiting, and bloating. Despite experiencing intermittent abdominal pain for 15 years, he had never undergone any abdominal procedure. Upon examination, no tenderness or distension was observed, but an abdominal radiograph indicated a distended small bowel. Subsequent contrast-enhanced abdominal computed tomography (CT) scan confirmed midgut malrotation with volvulus, showing a whirlpool sign. The patient received symptomatic treatment and was discharged for an elective Ladd's procedure. Conclusion: Intestinal malrotation is often missed in adults with non-specific abdominal symptoms, leading to delayed diagnosis. This emphasizes the importance of considering it in the differential diagnosis of suspected small bowel obstruction.
Ethical Statement
Ethics committee approval is not required for this study.
References
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Year 2025,
Volume: 42 Issue: 1, 92 - 94, 28.03.2025
Ömer Jaradat
,
Zamir Kemal Ertürk
,
Burak Şahin
References
- 1. Bhatia S, Jain S, Singh CB, Bains L, Kaushik R, Gowda NS. Malrotation of the Gut in Adults: An Often Forgotten Entity. Cureus. 2018 Mar 12;10(3):e2313. doi: 10.7759/cureus.2313. PMID: 29755909; PMCID: PMC5947924.
- 2. Haak BW, Bodewitz ST, Kuijper CF, de Widt-Levert LM. Intestinal malrotation and volvulus in adult life. Int J Surg Case Rep. 2014;5(5):259-61. doi: 10.1016/j.ijscr.2014.02.013. Epub 2014 Mar 13. PMID: 24709622; PMCID: PMC4008858.
- 3. Appel S, Zerem E, Bergman S, et al. Intestinal Malrotation in Adults: A Systematic Review of Surgical Management and Outcomes. J Gastrointest Surg. 2021;25(8):2137-2145.
- 4. American Pediatric Surgical Association. Guidelines for the management of intestinal malrotation. J Pediatr Surg. 2020;55(12):2590-5.
- 5. Gamblin TC, Stephens RE Jr, Johnson RK, Rothwell M. Adult malrotation: a case report and review of the literature. Curr Surg. 2003 Sep-Oct;60(5):517-20. doi: 10.1016/S0149-7944(03)00030-8. PMID: 14972216.
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- 9. Perez Galaz F, Moedano Rico K, Pérez Tristán FA, Acuña Macouzet A, Jafif Cojab M. Midgut volvulus caused by intestinal malrotation; A rare cause of acute abdomen in adults. Case report. Int J Surg Case Rep. 2020;73:355-359. doi: 10.1016/j.ijscr.2020.07.051. Epub 2020 Jul 18. PMID: 32745727; PMCID: PMC7398895.