Abstract
Congenital intestinal malrotation is an anomaly of intestinal rotation and fixation which occurs during fetal development. It is rare for a malrotation to be present in adulthood. Indeed, most adult patients are asymptomatic and are later discovered incidentally during operation for other clinical conditions. Here we presented a case of malrotation in a 79-year-old elderly man presented with intermittent colicky abdominal pain, obstipation and vomiting for 2 days. Abdominal examination revealed distended abdomen, tenderness at right upper abdominal quadrant and peritonism. A contrast-enhanced computed tomography scan of the abdomen showed small bowel malrotation with suspected volvulus. The patient underwent exploratory laparotomy in which the intraoperative findings were small bowel malrotation, tight Ladd's band and midgut volvulus on top of perforated gallbladder empyema. The patient also underwent cholecystectomy, release of Ladd's band, re-rotation of the bowel, fixation of caecum to the left lower quadrant and appendicectomy. A complete recovery and relief of gastrointestinal symptoms were achieved postoperatively.
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