Incidental intestinal malrotation in an adult: Midgut volvulus

Kafadar, Mehmet Tolga; Cengiz, Aysun Yakut; Çaviş, Tuğba; Bilgiç, İsmail; Nadir, İşılay

doi:10.5152/turkjsurg.2017.3468

Cited by 5 publications

(8 citation statements)

References 7 publications

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“…8 It is estimated that 1 in 500 newborns present intestinal malrotation; 8 80% of the cases become symptomatic within the first month of life, and 90% are diagnosed within the first year. 9 It is a rare disease in adults, reported in just 0.0001% to 0.19% 4,8 of the population; however, as most of the affected adult population is asymptomatic or presents non-specific symptoms, this number may be underestimated. The malformation is reported equally for men and women.…”

Section: Discussionmentioning

confidence: 99%

“…Some patients report chronic abdominal discomfort with no apparent cause, and the pain is commonly attributed to other pathologies prevalent in this age group. 9,10 In symptomatic cases, symptoms may present acutely or chronically. Vomiting, as well as pain without abdominal distention that may progress to ischemia, with intestinal necrosis and peritonitis, are associated with acute symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Given the risks, some professionals recommend performing elective laparotomy and the Ladd procedure. 5,9 The Ladd procedure has been the most widely-recommended procedure by both general and pediatric surgeons since 1936. It has been proven to improve symptoms and to reduce the risk of volvulus and intestinal ischemia.…”

Section: Discussionmentioning

confidence: 99%

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Intestinal Malrotation, Mesocolic Hernia, and Meckel Diverticulum – Differential Diagnosis of Abdominal Pain in Adults: Case Report and Literature Review

Costa

Alencastro

Linica

et al. 2021

Journal of Coloproctology

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Intestinal malrotation is a congenital anomaly caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. Embryonic development and its anatomical variations were described by Dott in 1923.Intestinal malrotation is a rare condition among adults – prevalent in a mere 0.0001% to 0.19% of the population –, and it may be associated with other anatomical deformities. It can be asymptomatic or manifest with varying intensity, from obstruction to necrosis of intestinal segments. In general, this abnormality is diagnosed in the first year of life; however, symptoms may appear later in life, making diagnosis in adults difficult on account of non-specific symptoms.In the present study, we report a case of intestinal malrotation associated with chronic non-specific symptoms progressing to mesenteric angina.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intestinal Malrotation, Mesocolic Hernia, and Meckel Diverticulum – Differential Diagnosis of Abdominal Pain in Adults: Case Report and Literature Review

Costa

Alencastro

Linica

et al. 2021

Journal of Coloproctology

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“…Intestinal malrotation is a rare fetal developmental abnormality which may go unnoticed until adulthood. It can be an incidental inding or present with mild symptoms, but it can also lead to an intestinal obstruction or acute ischemia due to a midgut torsion requiring emergency surgery [1]. Ladd's procedure is the standard treatment.…”

Section: Discussionmentioning

confidence: 99%

Intestinal malrotation presenting with midgut volvulus in an adult

Prats¹,

Montanuy²,

Aglio³

2019

Arch Case Rep

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“…The term encompasses all abnormalities caused by rotational errors during embryonic development of the midgut. The majority of intestinal malrotation (60–80%) presents in the neonatal period as an acute surgical emergency secondary to midgut volvulus [2] , [3] . Failure in recognition, or management of this diagnosis may lead to significant sequelae including short gut syndrome, intra-abdominal sepsis and/or death [1] .…”

Section: Introductionmentioning

confidence: 99%

Variations of intestinal malrotation in adults: A case report of midgut volvulus and literature review for the surgeon

Ribeiro¹,

Greene²,

Bennett³

et al. 2022

International Journal of Surgery Case Reports

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Introduction Intestinal malrotation is a rare congenital abnormality occurring in 0.2–1% of the population. Adult presentations comprise only 0.2–0.5% of all cases leading to diagnostic challenges and worse outcomes in adults. We present a rare case of chronic/intermittent midgut volvulus with unique anatomic findings in an adult with intestinal malrotation. Presentation of case An 18-year-old Caucasian male presented to a community hospital with abdominal pain, nausea, and vomiting. He underwent a CT scan demonstrating concern for small bowel volvulus and subsequently underwent a negative exploratory laparotomy. He was discharged post-operatively with no identified etiology for his presentation. He subsequently had multiple presentations to the ED with recurrent symptoms, review of imaging led to concern for duodenal volvulus resulting in transfer to a tertiary hepatobiliary centre. Repeat CT scan two weeks following initial presentation was consistent with intestinal malrotation with midgut volvulus. Bloodwork was unremarkable and physical exam demonstrated normal vital signs with a tender epigastrium. He underwent an exploratory laparotomy with Ladd's procedure. Intra-operative findings included a midgut volvulus and uniquely positioned Ladd's bands to the transverse colon. Post-operatively he tolerated oral intake and was discharged with three-month follow-up. Discussion Adults with intestinal malrotation suffer from delays in diagnosis and management. In contrast to the neonatal population, adults often present with vague, or chronic symptoms, which obscures the diagnosis. Conclusion The increased morbidity and mortality observed in adults with intestinal malrotation highlights the need for surgeons to appreciate the challenges associated with this diagnosis in the adult population to ensure early recognition and management.

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Incidental intestinal malrotation in an adult: Midgut volvulus

Cited by 5 publications

References 7 publications

Intestinal Malrotation, Mesocolic Hernia, and Meckel Diverticulum – Differential Diagnosis of Abdominal Pain in Adults: Case Report and Literature Review

Intestinal Malrotation, Mesocolic Hernia, and Meckel Diverticulum – Differential Diagnosis of Abdominal Pain in Adults: Case Report and Literature Review

Intestinal malrotation presenting with midgut volvulus in an adult

Variations of intestinal malrotation in adults: A case report of midgut volvulus and literature review for the surgeon

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