Abdominal pain and intestinal malrotation in adults.

A 29-year-old male presented symptoms of pain in the upper abdomen accompanied by vomiting. Of relevance in his medical history, the patient reported episodes of recurrent chronic abdominal pain and vomiting. An abdominal CAT-scan was performed (Fig. 1) which showed an anomalous arrangement of the bowel loops located in the upper abdomen. It also revealed a horseshoe-kidney and signs of bowel obstruction with volvulus secondary to intestinal malrotation. Laparotomy was then performed and transmesocolic herniation of all bo wel loops with volvulus and fixation by Ladd’s bands was found. Ladd’s procedure was then performed by cutting all the bands and rotating the bowel loops to reduce the volvulus and closing the mesocolon orifice. On finding the bowel completely viable, resection was not required. Post-operative outcome followed a favorable course without complications.