Intestinal nonrotation is a subtype of malrotation occurring when the midgut fails to rotate before returning to the peritoneal cavity between weeks 8-10 of development. Though sometimes presenting as volvulus during the neonatal period, a subset of patients remains asymptomatic and are identified incidentally as adults. When patients with intestinal nonrotation present with abdominal symptoms, there exists a diagnostic dilemma for the treating surgeon. We present the case of a patient who presented with acute abdominal pain and vomiting, with radiographic findings of intestinal nonrotation and no other acute pathology. Symptoms spontaneously resolved with conservative management for likely etiology of viral gastroenteritis. At the one-month follow-up, the patient had no residual or recurrent symptoms, with no further interventions planned.
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http://dx.doi.org/10.7759/cureus.29153 | DOI Listing |
J Pediatr Surg
September 2024
Norton Children's Hospital, Department of Pediatric Surgery, 231 E Chestnut St, Louisville, KY 40202, USA. Electronic address:
Introduction: Symptomatic malrotation requires urgent Ladd procedure. Patients with incidental or indeterminate findings have historically been managed with observation or operatively. Fluoroscopic identification of the duodenojejunal junction (DJJ) and ileocecal junction (ICJ) can guide operative decision-making, but algorithms have not been validated.
View Article and Find Full Text PDFRadiol Case Rep
October 2024
Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia.
Intestinal nonrotation is the most common type of mid-gut anomaly where the small bowel predominantly occupies the right side of the peritoneal cavity, while the colon primarily resides on the left. The occurrence of acute appendicitis in mid-gut anomalies poses a serious diagnostic challenge due to unprecedented clinical and imaging features. Here we present a 20-year-old female who came to the hospital with left lower abdominal pain of 3 weeks duration, referred with a diagnosis of tubo-ovarian abscess.
View Article and Find Full Text PDFAnn Ital Chir
August 2024
Department of Surgery, College of Medicine, Qassim University, 52571 Buraydah, Al‑Qassim, Saudi Arabia.
Aim: Intestinal malrotation (IM) represents a rare congenital anomaly in adults, although it is more common during infancy. This condition originates during embryonic development due to incomplete rotation of the midgut around the superior mesenteric vessels. The primary aim of this case study is to emphasize the importance of surgeon awareness and recognition of this congenital anomaly during laparoscopic gastric surgery to avoid serious complications.
View Article and Find Full Text PDFAsian J Endosc Surg
October 2024
Division of Frontier Surgery, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Managing colon cancer with intestinal nonrotation, a type of congenital intestinal malrotation, is challenging due to the presence of anatomical abnormalities and severe adhesions. When patients have nonrotation, it is markedly more difficult to determine which vessels correspond to the colic vessels and ileal vessels until all vascular branching patterns become evident. The optimal approach for right-sided colon cancer with intestinal nonrotation has yet to be established.
View Article and Find Full Text PDFCureus
March 2024
General Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Vila Real, PRT.
Intestinal malrotation (IM), a rare congenital anomaly disrupting typical embryonic rotation around the superior mesenteric artery, is exceptionally uncommon in adults, with its link to colon cancer being even rarer. This article presents a case of colonic cancer in conjunction with IM in a 63-year-old male. Image studies and intraoperative findings show signs of IM.
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