Midgut volvulus secondary to congenital malrotation in an adult with Ladd’s band: a case report
DOI:
https://doi.org/10.18203/2349-2902.isj20243553Keywords:
Case report, Adult, Midgut volvulus, Ladd's band, MalrotationAbstract
Adult midgut volvulus is a rare surgical disease, with an estimated incidence of less than 0.15%, and more common in Asia and Africa as compared to Europe and the US. It is a developmental anomaly characterized by failure to complete normal fetal rotation of the midgut around the Superior Mesenteric Artery (SMA) inside the peritoneal cavity. Though rare, adult midgut volvulus has the potential for bowel ischemia-related complications, and thus clinicians should have a reasonable index of suspicion to diagnose this. Early computed tomography (CT) scan with diagnostic accuracy of more than 83% would help in early recognition and management of these rare causes of intestinal obstruction. In this study, we reported the case of an adult primary midgut volvulus in a 30-year-old male who presented with features of acute bowel obstruction with a history of similar recurrent episodes and renal transplant. Diagnosis of midgut volvulus was made based on contrast-enhanced CT findings, and Ladd’s procedure was performed.
References
Low SF, Ngiu CS, Sridharan R, Lee YL. Midgut malrotation with congenital peritoneal band: a rare cause of small bowel obstruction in adulthood. BMJ. 2014;7:13202690.
Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler AJ, Orgill DP. The SCARE 2018 statement: Updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg. 2018;60:132–6.
Leow JJ., Huey, T., & Low, J. K. (2016). Primary adult midgut volvulus mimicking acute appendicitis: A case report and review of the literature. Int J Surg. 2016;24:182–4.
Singh S, Das A, Chawla A, Arya S, Chaggar J. A rare presentation of midgut malrotation as an acute intestinal obstruction in an adult: Two case reports and literature review. International Journal of Surgery Case Reports. 2013;4(1):72–5.
Aslanabadi S, Ghalehgolab-Behbahan A, Jamshidi M, Veisi P, Zarrintan S. Intestinal malrotations: a review and report of thirty cases. Folia Morphol (Warsz). 2007;66(4):277-82.
Gamblin T, Stephens RE, Johnson RK, Rothwell M. Adult malrotation. Current Surg. 2003;60(5):517–20.
Coste AH, Anand S, Nada H, Ahmad H. Midgut Volvulus. StatPearls. NCBI Bookshelf. Available at: https://www.ncbi.nlm.nih.gov. Accessed on 8 August 2024.
Lieu DQ, Dung TN, Long TB, Anh TN, Dung LQ, Duc NM. A rare case of Ladd’s band causing duodenal occlusion in an adult with intestinal malrotation. Radiol Case Rep. 2023;18(10):3735–8.
Zissin R, Rathaus V, Oscadchy A, Kots E, Gayer G, Shapiro FM. Intestinal malrotation as an incidental finding on CT in adults. Abdominal Radiol. 1999;24(6):550–5.
Epelman M. The Whirlpool Sign. Radiol. 2006;240(3):910–11.
De Korte N, Grutters CT, Snellen JP. Small Bowel Volvulus Diagnosed by the CT “Whirl Sign.” J Gastrointes Surg. 2008;12(8):1469–70.
Grassi C, Conti L, Palmieri G, Banchini F, Dacco MD, Cattaneo GM, Capelli P. Ladd’s band in the adult, an unusual case of occlusion: Case report and review of the literature. Int J Surg Case Reports. 2000;71:45–9.
Spigland N, Brandt ML, Yazbeck S. Malrotation presenting beyond the neonatal period. Journal of Pediatric Surg. 1990;25(11):1139–42.
Mazziotti MV, Strasberg SM, Langer JC. Intestinal rotation abnormalities without volvulus: The role of laparoscopy. J American Coll Surg. 1997;185(2):172–6.
Butterworth WA, Butterworth JW. An adult presentation of midgut volvulus secondary to intestinal malrotation: A case report and literature review. Int J Surg Case Rep. 2018;50:46–9.
