Acute surgical abdomen as presentation of undiagnosed midgut malrotation in adults

Avgoustou, Constantinos; Manatakis, Dimitrios K.

doi:10.1007/s13126-017-0391-5

Cited by 3 publications

(17 citation statements)

References 23 publications

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“…Hsieh TM et al 17 reported an adult with malrotation and ileoileal intussusception due to inflammatory fibroid polyp which was managed with segmental small bowel resection. Chaudhary P et al ,18 Iinuma N et al 19 and Avgoustou C et al 20 described cases of malrotation with ileocolic intussusception which were managed surgically. We believe this is the first report of malrotation with colocolic intussusceptionin English literature.…”

Section: Discussionmentioning

confidence: 99%

Adult with intestinal malrotation and colocolic intussusception: an unusual combo

Gandhi¹,

Pai

Kashiva

et al. 2019

BMJ Case Rep

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Intestinal malrotation is a congenital anomaly that results from an abnormality in the rotation and fixation of the gut as it returns to the abdominal cavity during development. Intussusception is a condition characterised by telescoping of one segment of the bowel into another segment. The combination of malrotation and intussusception is frequently a cause of intestinal obstruction in the paediatric age group. The coexistence of these two conditions is termed as Waugh syndrome and is uncommon in adults. We share our experience with an elderly woman who was admitted with diarrhoea and anaemia. Investigations revealed a large colonic polyp, colocolic intussusception and malrotation. The adenomatous polyp and mobile right colon would have lead to intussusception. The diagnosis was based on the findings of colonoscopy and contrast-enhanced CT scan of the abdomen. She was managed with a transverse colectomy with an uneventful recovery.

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Section: Discussionmentioning

confidence: 99%

Adult with intestinal malrotation and colocolic intussusception: an unusual combo

Gandhi¹,

Pai

Kashiva

et al. 2019

BMJ Case Rep

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“…Midgut malrotation (MGM) refers to a wide spectrum of congenital abnormalities occurring as a result of partial or complete failure or arrest of the normal 270 o intestinal rotation and fixation process during embryonary period, which may present within the peritoneal cavity as abnormal position of the intestines, especially the right colon, the small intestine with its mesentery, and even the duodenum [1][2][3][4] . This congenital abnormality is usually an isolated condition with an incidence in general population one for every 200-500 newborns and symptomatic cases occurring in one to 6000 newborns, sometimes it is associated with congenital heart disease or situs or biliary tract anomalies; it is mostly recognized and treated by pediatric surgeons 1,2,5 .…”

Section: Introductionmentioning

confidence: 99%

“…vague abdominal pain) or recurrent intermittent bowel obstruction, and a minority with acute or fulminating bowel obstruction due to caecocolic mobility and torsion or even bowel invagination,which may lead to bowel necrosis 3,[8][9][10][11] . Adult caecocolic torsion is a class of right colon volvulus (RCV), and MGM is always associated with an increased risk of this devastating complication 4,7,9 . The more rare bowel invagination in cases with underlying MGM, namely ileocolonic intussusception (ICI), may present independently or coexisting with RCV 3,9,11 .…”

Section: Introductionmentioning

confidence: 99%

“…The wide range of rotation and fixation defects ascribed, resulting in accordance to the stage at which the embryologic error occurred, is the explanation of the wide and more obscure constellation of clinical symptoms during adulthood, and the reason why the diagnosis of MGM is often delayed 4,12 . In addition, the index of suspicion for MGM progressively decreases in the older population and ,thus, the clinical diagnosis is not considered in the initial evaluation 1,12 .…”

Section: Introductionmentioning

confidence: 99%

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Complicated Adult Midgut Malrotation: A Challenge to Diagnose and Treat

Avgoustou¹

2019

wjoncgy

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Midgut malrotation (MGM) refers to a broad spectrum of rotation and fixation anomalies of the gut during fetal development, which are clinically evident mostly early in life as newborn emergencies and rarely later as milder forms in adults. Most commonly, adult patients are asymptomatic throughout life or they are insidiously presenting unspecific symptoms for a significant period of time before the diagnosis is made. Less commonly, adult MGM cases are acutely complicated with challenging and life-threatening conditions, such as the obstructive midgut or right colon volvulus and the ileocolonic intussusception, which require prompt diagnosis, intensive resuscitation and emergent surgical intervention. Intentionally, high index of suspicion and awareness are essential, if bowel infarction is to be prevented and high morbidity and mortality reduced.

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“…The first report by C. Avgoustou et al [3] describes four cases of right colonic volvulus, which were suspected using imaging studies and diagnosed and managed intraoperatively. Colonic volvulus is the twisting of the bowel on its mesenteric vessel axis, resulting in obstruction and varying degrees of vascular impairment.…”

mentioning

confidence: 99%

Our case reports a component of acute care surgery

Marinis

2017

Hellenic J Surg

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Acute surgical abdomen as presentation of undiagnosed midgut malrotation in adults

Cited by 3 publications

References 23 publications

Adult with intestinal malrotation and colocolic intussusception: an unusual combo

Adult with intestinal malrotation and colocolic intussusception: an unusual combo

Complicated Adult Midgut Malrotation: A Challenge to Diagnose and Treat

Our case reports a component of acute care surgery

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