Case Report
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An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult

Year 2025, Volume: 42 Issue: 1, 92 - 94, 28.03.2025

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

  • 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.
  • 6. Neville JJ, Gallagher J, Mitra A, Sheth H. Adult Presentations of Congenital Midgut Malrotation: A Systematic Review. World J Surg. 2020 Jun;44(6):1771-1778. doi: 10.1007/s00268-020-05403-7. PMID: 32030442.
  • 7. Herle P, Halder T. Intestinal malrotation in an adult patient with other congenital malformations: A case report. Int J Surg Case Rep. 2018;51:364-367. doi: 10.1016/j.ijscr.2018.09.010. Epub 2018 Sep 18. PMID: 30261479; PMCID: PMC6157462.
  • 8. Kafadar MT, Cengiz AY, Çaviş T, Bilgiç İ, Nadir I. Incidental intestinal malrotation in an adult: Midgut volvulus. Turk J Surg. 2018 Dec 1;34(4):337-339. doi: 10.5152/turkjsurg.2017.3468. PMID: 30664437; PMCID: PMC6340649.
  • 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.
Year 2025, Volume: 42 Issue: 1, 92 - 94, 28.03.2025

Abstract

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.
  • 6. Neville JJ, Gallagher J, Mitra A, Sheth H. Adult Presentations of Congenital Midgut Malrotation: A Systematic Review. World J Surg. 2020 Jun;44(6):1771-1778. doi: 10.1007/s00268-020-05403-7. PMID: 32030442.
  • 7. Herle P, Halder T. Intestinal malrotation in an adult patient with other congenital malformations: A case report. Int J Surg Case Rep. 2018;51:364-367. doi: 10.1016/j.ijscr.2018.09.010. Epub 2018 Sep 18. PMID: 30261479; PMCID: PMC6157462.
  • 8. Kafadar MT, Cengiz AY, Çaviş T, Bilgiç İ, Nadir I. Incidental intestinal malrotation in an adult: Midgut volvulus. Turk J Surg. 2018 Dec 1;34(4):337-339. doi: 10.5152/turkjsurg.2017.3468. PMID: 30664437; PMCID: PMC6340649.
  • 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.
There are 9 citations in total.

Details

Primary Language English
Subjects General Surgery, Emergency Medicine, Radiology and Organ Imaging
Journal Section Case Report
Authors

Ömer Jaradat 0000-0002-6177-710X

Zamir Kemal Ertürk 0000-0001-6837-2028

Burak Şahin 0000-0003-3990-7374

Publication Date March 28, 2025
Submission Date June 7, 2024
Acceptance Date March 26, 2025
Published in Issue Year 2025 Volume: 42 Issue: 1

Cite

APA Jaradat, Ö., Ertürk, Z. K., & Şahin, B. (2025). An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult. Journal of Experimental and Clinical Medicine, 42(1), 92-94.
AMA Jaradat Ö, Ertürk ZK, Şahin B. An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult. J. Exp. Clin. Med. March 2025;42(1):92-94.
Chicago Jaradat, Ömer, Zamir Kemal Ertürk, and Burak Şahin. “An Often-Forgotten Diagnosis: Midgut Malrotation and Volvulus in an Adult”. Journal of Experimental and Clinical Medicine 42, no. 1 (March 2025): 92-94.
EndNote Jaradat Ö, Ertürk ZK, Şahin B (March 1, 2025) An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult. Journal of Experimental and Clinical Medicine 42 1 92–94.
IEEE Ö. Jaradat, Z. K. Ertürk, and B. Şahin, “An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult”, J. Exp. Clin. Med., vol. 42, no. 1, pp. 92–94, 2025.
ISNAD Jaradat, Ömer et al. “An Often-Forgotten Diagnosis: Midgut Malrotation and Volvulus in an Adult”. Journal of Experimental and Clinical Medicine 42/1 (March 2025), 92-94.
JAMA Jaradat Ö, Ertürk ZK, Şahin B. An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult. J. Exp. Clin. Med. 2025;42:92–94.
MLA Jaradat, Ömer et al. “An Often-Forgotten Diagnosis: Midgut Malrotation and Volvulus in an Adult”. Journal of Experimental and Clinical Medicine, vol. 42, no. 1, 2025, pp. 92-94.
Vancouver Jaradat Ö, Ertürk ZK, Şahin B. An often-forgotten diagnosis: Midgut malrotation and volvulus in an adult. J. Exp. Clin. Med. 2025;42(1):92-4.