91 Intestinal Malrotation Identified on Diagnostic Laparoscopy in a 79-Year-Old Male Presenting With Symptoms of Sub-Acute Bowel Obstruction

Abstract

Abstract Congenital malrotation of the midgut in the adult population is most likely to present with non-specific abdominal symptoms that can pose a diagnostic dilemma. If left untreated the symptoms of malrotation can have a significant impact on patients’ quality of life and the condition can lead to significant morbidity and mortality. We report a case of malrotation identified in a 79-year-old male who presented with a chronic picture suggestive of sub-acute small bowel obstruction. The patient underwent thorough clinical review including CT and MRI scan which showed evidence of dilated small bowel but failed to show an underlying cause. The absence of findings with initial tests prompted the team to consider surgical investigation. Diagnostic laparoscopy identified evidence of congenital malrotation, and this was successfully treated with a Ladd’s procedure. This case adds to the evidence that malrotation is a more common finding in adults than previously thought and emphasises the importance of pursuing a definitive diagnosis when routine tests do not demonstrate sufficient cause for a patient’s symptoms.