Adult Intestinal Malrotation: A Case Report

Midgut malrotation is an anomaly of intestinal rotation which occurs during fetal development and usually presents in the neonatal period. It is rare for malrotation to present in adulthood. We present a case of malrotation in an adult female patient who presented with cramping generalized right abdominal pain and vomiting of one day duration. A computed tomography abdominal scan and upper gastrointestinal contrast studies showed malrotation of the small bowel. The patient was consented for exploratory laparotomy during which typical Ladd’s bands and a distended flabby third and fourth duodenal portion extrinsically obstructing the misplaced duodeno-jejunal junction were recognized. Detorsion of the twisted mesentery, lysis of the bands, appendectomy and a side-to-side duodeno-jejunal anastomosis were performed. Complete resolution of symptoms is noted in a two-year follow-up period.