Gangrenous Adult Midgut Volvulus from Midgut Malrotation: A Case Report

Malrotation of the midgut is mainly a childhood congenital anomaly. Adult Midgut malrotation is rare with the clinical symptomatology varied and non-specific making pre-operative diagnosis difficult. Midgut volvulus from malrotation is a true surgical emergency requiring early intervention to prevent bowel necrosis and death.We report a 27yr old male who was referred to our centre with paralytic ileus post appendectomy. He underwent emergency laparotomy with findings of gangrenous volvulus involving almost the entire midgut from malrotation. He had bowel resection with jejunocolic anastomosis. Post-operatively he was referred on account of short bowel.A high index of suspicion is needed in acute abdomen with atypical features to allow for early diagnosis and prompt intervention to avert this catastrophic event.