Re-do Roux-en-Y Gastric Bypass in a Patient with Known Midgut Malrotation

Karim, Muhammad Ali; Mansour, Moustafa; Ali, Abdulmajid

doi:10.4293/108680813x13753907291990

Cited by 6 publications

(1 citation statement)

References 17 publications

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“…In case of MM, the most commonly encountered presentation is the inability of cecum positioned to the right-lower quadrant and the pressure on the duodenum due to peritoneal Ladd's bands that fix the ectopically established cecum to the posterior wall [ 15 ]. Following description of the reduction of volvulus for the first time in 1932, Ladd described the liberalization of the bands that apply pressure to duodenum.…”

Section: Discussionmentioning

confidence: 99%

Midgut Malrotation Causing Intermittent Intestinal Obstruction in a Young Adult

Bektaşoğlu

İdiz

Hasbahçeci

et al. 2014

Case Reports in Surgery

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Section: Discussionmentioning

confidence: 99%

Midgut Malrotation Causing Intermittent Intestinal Obstruction in a Young Adult

Bektaşoğlu

İdiz

Hasbahçeci

et al. 2014

Case Reports in Surgery

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Adult Presentations of Congenital Midgut Malrotation: A Systematic Review

et al. 2020

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Background Adult midgut malrotation is a rare cause of an acute abdomen requiring urgent intervention. It may also present in the non-acute setting with chronic, non-specific symptoms. The objective of this study is to identify the clinical features, appropriate investigations and current surgical management associated with adult malrotation. Methods A systematic review was conducted according to PRISMA guidelines, identifying confirmed cases of adult malrotation. Patient demographics, clinical features, investigation findings and operative details were analysed. Results Forty-five reports met the inclusion criteria, totalling 194 cases. Mean age was 38.9 years (n = 92), and 52.3% were male (n = 130). The commonest presenting complaints were abdominal pain (76.8%), vomiting (35.1%) and food intolerance (21.6%). At least one chronic symptom was reported in 87.6% and included intermittent abdominal pain (41.2%), vomiting (12.4%) and obstipation (11.9%). Computerised tomography scanning was the most frequent imaging modality (81.4%), with a sensitivity of 97.5%. The whirlpool sign was observed in 30.9%; abnormalities of the superior mesenteric axis were the commonest finding (58.0%). Ladd's procedure was the most common surgical intervention (74.5%). There was no significant difference in resolution rates between emergency and elective procedures (p = 0.46), but length of stay was significantly shorter for elective cases. (p = 0.009). There was no significant difference in risk of mortality, or symptom resolution, between operative and conservative management (p = 0.14 and p = 0.44, respectively). Conclusion Malrotation in the adult manifests with chronic symptoms and should be considered as a differential diagnosis in patients with abdominal pain, vomiting and food intolerance. Abbreviations CTComputerised tomography MRI Magnetic resonance imaging SMA Superior mesenteric axis

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