An adult presentation of midgut volvulus secondary to intestinal malrotation: A case report and literature review

Abstract

HighlightsMidgut volvulus secondary to intestinal malrotation is a rare cause of acute abdomen in adults.There are only 92 reported cases in the literature.Diagnosis of the midgut volvulus was predominantly made via CT (67%) but also by ultrasound (15%) and theatre (18%).Midgut volvulus is associated with a high risk of ischaemia and necrosis of bowel supplied by the SMA (35).There is a 5% associated mortality rate.

Recurrent midgut volvulus in an adult patient — The case for pexy? A case report and review of the literature

“…Given the lower incidence of adult midgut volvulus (there are about 120 case reports and another 200 patients reported in 14 case series in the literature) the recurrence rate among adult patients is harder to estimate [3,[5], [6], [7], [8], [9], [10],[17], [18], [19], [20], [21], [22], [23], [24]].…”

“…Congenital intestinal malrotation is commonly diagnosed during childhood: an estimated 90% of patients are diagnosed during the first year of life [1,2] and adult presentations are rare and reported to account for only 0.2-0.5% of intestinal malrotation cases [[3], [4], [5], [6]]. Adult presentations are most commonly either incidental findings on radiological studies or chronic non-specific complaints such as abdominal pain or intermittent episodes of bowel obstruction.…”

“…In a cohort of 82 adult patients Nehra et al reported the most common complaints to be abdominal pain (present in 87% of patients), emesis (present in 37% of patients) and nausea (present in 31% of patients). Although only an estimated 15% of adults with malrotation present with midgut volvulus, it is the most worrisome complication of intestinal malrotation: in the absence of timely diagnosis a midgut volvulus may have catastrophic consequences with progression to gangrene of the rotated gut, sepsis and the need for extensive small bowel resection with subsequent short bowel syndrome [1,3,7].…”

Midgut volvulus caused by intestinal malrotation; A rare cause of acute abdomen in adults. Case report

“…More importantly midgut volvulus is a rare presentation of cause acute abdomen in the adult population with only 93 cases reported in literature [ 14 ]; these patients present severe abdominal pain, signs of intestinal obstruction, hematemesis or hematochezia and in some occasions with hemodynamic instability [ 5 , 6 , 14 ].…”

Rare case of midgut volvulus with malrotation in an elderly patient

“…If not diagnosed timely a midgut volvulus can lead to devastating complications, with up to 19% requiring major bowel resection and even death. 1 Through this article we would to present our experience and difficulties faced in diagnosis and management.…”