Midgut Malrotation in Aduithood.

Kanazawa, Tamotsu; Kasugai, Kunio; Miyata, Mitsuki; Miyashita, M.; Mizuno, Mari; Nagase, Fumitaka; Hibino, K; Muramatu, Wataru; Hayashi, Keisuke; Aihara, Mariko; Yoshida, Toshiaki; Utsumi, Keiko; Nitta, Masakazu

doi:10.2169/internalmedicine.39.626

Cited by 24 publications

(10 citation statements)

References 9 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The staged return of midgut within abdominal cavity involves rotation and fixation which can be anomalous in different stages leading to malrotation of the gut. The classification of different rotational anomalies and their clinical significance are given in Table 4 [2].…”

Section: Discussionmentioning

confidence: 99%

“…In adults, usually, it is asymptomatic and detected during investigations, operation or autopsy. Rarely, it may cause chronic abdominal pain, intestinal obstruction and even volvulus in adults [1][2][3]. This report describes a case of iron deficiency anaemia and dyspepsia which, on investigation, found to have carcinoma caecum with malrotation of the gut.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Malrotation of the Intestine in Adult and Colorectal Cancer

Ray

Morimoto

2015

Indian J Surg

View full text Add to dashboard Cite

Malrotation of the gut is a congenital anomaly and usually presents in childhood. Rarely, it may present in adults. Patients may be asymptomatic, and malrotation is detected during investigations, operation or autopsy. It can cause longstanding abdominal symptoms like pain, dyspepsia or acute abdomen due to volvulus. In adults, malrotation is found with different gastrointestinal malignancies like gastric, hepatobiliary, pancreatic and, in particular, colorectal neoplasms. We are reporting a case of 60-year-old female presented with carcinoma caecum along with malrotation of the gut. It is the first case report from India. We also reviewed documented cases of malrotation associated with colorectal malignancies. A large number of cases have been reported in Japan as compared to rest of the world. Malrotation in adults is probably associated with gastrointestinal malignancies. Possible causes of this association can be genetic factors or gut changes like chronic inflammation. These associations need further study to consider intestinal malrotation as premalignant lesion which may be very important in follow-up of children with malrotation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Malrotation of the Intestine in Adult and Colorectal Cancer

Ray

Morimoto

2015

Indian J Surg

View full text Add to dashboard Cite

show abstract

“…1). The incidences of nonrotation and incomplete rotation of both limbs are high, and various studies have been reported [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

A Case of Cancer of the Ampulla of Vater Accompanied by Malrotation

et al. 2013

View full text Add to dashboard Cite

Intestinal malrotation is caused by a developmental anomaly of the embryonic intestine. Most cases develop in neonates, and development in adulthood is rare and difficult to diagnose before surgery. Pancreaticoduodenectomy was performed for cancer of the ampulla of Vater accompanied by incomplete fixation in a 63-year-old male patient. A branch of the superior mesenteric artery was present on the resection line and was deemed likely to cause circulatory disorder in the small intestine, and the duodenum and jejunum were covered with a membranous structure making dissection, anatomical identification, and jejunectomy difficult. Herein, we report the case with a review of the literature.

show abstract

“…Most cases have been estimated to present in their early life, and less than 0.5 % of cases are identified in adulthood [2]. It has been classified into three major types, including non-rotation (type I), duodenal malrotation (type II), and combined duodenal and cecal malrotation (type III), according to the stage at which the embryologic error occurs [3,4]. This present patient is in the nonrotation type (type I), which is characterized by right-sided duodenojejunal junction, left-sided lying cecum, and transposition of the superior mesenteric artery and vein [5].…”

mentioning

confidence: 99%

“…In type II malrotation, patients may manifest as duodenal obstruction due to non-rotation of the duodenum (type IIA), or transverse colon obstruction by superior mesenteric vessels due to reverse rotation of the duodenum and colon (IIB), and paraduodenal hernia due to reverse rotation of duodenum (IIC). In type III malrotation, patients may manifest midgut volvulus due to non-rotation of colon (IIIA), duodenal obstruction by Ladd's bands (IIIB), cecal volvulus due to incomplete attachment of cecum (IIIC), or internal hernia near the Treitz ligament (IIID) [4]. The CT scan can be used preoperatively to classify the midgut malrotation accordingly.…”

mentioning

confidence: 99%

Left-Sided Appendicitis in an Elderly Patient with Midgut Malrotation

et al. 2014

View full text Add to dashboard Cite

Appendicitis is a common surgical abdominal disease with various presentations. Its diagnosis may be obscured by asymptomatic congenital anatomical anomalies like midgut malrotation. Midgut malrotation is a rare fetal anomaly resulting from incomplete or failure of midgut rotation and fixation. It is mostly presented with bowel obstruction or volvulus in early life. Presentation in adult is rare. Here, we report an elderly patient presented with left lower abdominal pain and urinary tract infection. Abdominal computed tomography revealed left-sided appendicitis with non-rotational-type midgut malrotation. Clinicians should bear in mind the possibility of underlying midgut malrotation, as appendicitis could be the first presentation of this rare congenital condition.Keywords Acute appendicitis . Left-sided appendicitis . Midgut malrotation . Intestinal malrotation A 77-year-old female with diabetes presented to our emergency department with poor appetite, lower abdominal pain, and dysuria for 3 days. Physical examination revealed whole abdominal tenderness with mild rebounding pain, especially in the left lower abdomen. Laboratory examination showed no leukocytosis, but hyperglycemia, elevated C-reactive protein (32 mg/dl), and pyuria (urine WBC>100/HPF). An abdominal plain film only showed some large bowel gas in the left hemiabdomen. Because of the progression of abdominal pain, a computed tomography (CT) was done and incidentally found a congenital midgut malrotation with characteristics of transposition of the superior mesenteric artery (Fig. 1a-c, red arrows) and vein (Fig. 1a-c, white arrows), left-sided lying colon, and right-sided lying small intestine (Fig. 1c). A swollen appendix with fecalith and periappendiceal fat stranding were also found (Fig. 2a, b, red arrows). Emergency operation revealed ruptured acute appendicitis with peritonitis. The histopathologic finding of the resected appendix revealed a suppurative stage of acute appendicitis (Fig. 3). After appendectomy with drainage and antibiotics treatment, the patient was discharged uneventfully 8 days later.Midgut malrotation is a rare fetal anomaly resulting from incomplete or failure of midgut rotation and fixation during embryonic development [1]. Most cases have been estimated to present in their early life, and less than 0.5 % of cases are identified in adulthood [2]. It has been classified into three major types, including non-rotation (type I), duodenal malrotation (type II), and combined duodenal and cecal malrotation (type III), according to the stage at which the embryologic error occurs [3,4]. This present patient is in the nonrotation type (type I), which is characterized by right-

show abstract

Midgut Malrotation in Aduithood.

Cited by 24 publications

References 9 publications

Malrotation of the Intestine in Adult and Colorectal Cancer

Malrotation of the Intestine in Adult and Colorectal Cancer

A Case of Cancer of the Ampulla of Vater Accompanied by Malrotation

Left-Sided Appendicitis in an Elderly Patient with Midgut Malrotation

Contact Info

Product

Resources

About