Korean J Gastroenterol.  2013 May;61(5):282-285. 10.4166/kjg.2013.61.5.282.

Midgut Volvulus in a 70-year-old Man Due to Intestinal Nonrotation

• Jie BS
• Kim EO
• Kim JS
• Lee HJ
• Song YM
• Kim Y
• Jung SH
• Oh JH

• KMID: 1501651
• DOI: http://doi.org/10.4166/kjg.2013.61.5.282

Abstract

Intestinal malrotation is a congenital disorder that results from the failure of normal bowel rotation and fixation during the 5th gestational week. The incidence of intestinal malrotation is <0.2%, but prompt diagnosis is important because this anomaly can cause midgut volvulus and lead to fatalities. Compared to infants presenting with acute symptoms, such as abdominal pain, vomiting, or diarrhea, adult patients complain of intermittent self-limited abdominal pain. We present a case of intestinal malrotation complicated by midgut volvulus improved with conservative care in a 70-year-old man. The diagnosis was suggested on the basis of imaging findings.

Keyword

Familial intestinal malrotation; Intestinal Volvulus

MeSH Terms

Aged
Angiography
Colonic Diseases/*diagnosis/radiography
Diagnosis, Differential
Humans
Intestinal Volvulus/*diagnosis/radiography
Male
Mesenteric Artery, Superior/radiography
Tomography, X-Ray Computed

Figure

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  Fig. 1. (A) Abdominal CT demonstrated the superior mesenteric artery (SMV) (arrow) located in the upper abdomen and to the left of the SMA (arrow head), inversion of the SMA and superior mesenteric vein. (B) Whirling appearance of mesenteric vessels around the SMA.

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  Fig. 2. CT angiography showed clockwise corkscrew appearance (barber's pole sign) of the superior mesenteric vein (arrow).

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  Fig. 3. Upper gastrointesinal series showed duodenum and jejunal loop (arrows) located on the right side of the abdomen.

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  Fig. 4. Upper gastrointesinal series 80 min (A) and 120 min (B) after ingestion. The position of the cecum was not clear, but the ileocecal valve was located in the upper abdomen; most of the colon was on the left side of the abdomen.

Reference

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