A Case of Intestinal Malrotation in Adult

Park, Geun Tae; Choi, Chun Sik; Jeong, Jin Woog; Jo, Yun Joo; Park, Mun Sung; Lee, Oh Young; Han, Dong Soo; Son, Joo Hyn; Yoon, Byoung Chul; Choi, Ho Sun; Lee, Min Ho; Ki, Chun Suk; Park, Kyoung Nam; Kwon, Oh Jeong; Lim, Hyn Chul

Abstract

Intestinal malrotation is a rare disorder typically found in childhood. In adults it is an uncommon disease, and usually presents as bowel obstruction. Occasionally the clinical picture is confusing and the diagnosis of mahotation is not discovered until operation. Intestinal malrotation represents an arrest in the normal counterclockwise rotation of the cecum from the left lower quadrant to the right upper quadrant. The example is nondescent of the cecum, in which this structure remains in the subhepatic position. These are the diagnostic problems of differentiating between acute appendicitis and acute cholecystitis and the difficulty of appendectomy through a lower abdominal incision. In some patients, the cecum that cross the duodenum (Ladd's bands) is often fixed in an abnormal position by dense adhesion. In addition, the colon and the small intestine have a common mesentery with a lack of fixation to the lateral and posterior regions of the abdominal cavity. The usual rnechanism of obstruction is adhesive compression of the duodenum and volvulus of the small intestine. Herein we experienced the case with intestinal malrotation associated with Ladd's bands with duodenal compression, presenting with acute abdominal pain and vomiting.