Abstract
IntroductionIntestinal malrotation is a congenital anatomical anomaly resulting from abnormal midgut rotation. Many cases occur during childhood and present with intestinal obstruction and midgut volvulus. Intestinal malrotation rarely occurs in adults and is found incidentally because it is asymptomatic. We herein report a case of intestinal malrotation, and colorectal cancer operated laparoscopically. Presentation of caseA 78-year-old man presented to our Department of Surgical Gastroenterology with fecal occult blood. There were no abnormal findings in the physical examination. Colonoscopy revealed a type 3 tumor in the cecum. Contrast-enhanced computed tomography revealed that the tumor was located in the appendix along the midline of the abdomen. The small intestine and colon occupied the right and left sides of the abdominal cavity, respectively. The diagnosis was appendiceal cancer with nonrotation-type intestinal malrotation. A laparoscopy-assisted ileocecal resection was performed. During surgery, the right-side colon was not fixed to the retroperitoneum, and the right-side colon could be extracted out of the abdominal cavity through the umbilical wound with only adhesive dissection, and mesenteric and lymph node dissection can be performed outside the body. The postoperative course was uneventful. DiscussionAppendiceal cancer with intestinal malrotation is managed with laparoscopic surgery because this method is safe and minimally invasive. ConclusionThe laparoscopic approach may be safer and less invasive than laparotomy, and extracorporeal lymph node dissection is safe and reliable for patients with intestinal malrotation.
Highlights
Intestinal malrotation is a congenital anatomical anomaly resulting from abnormal midgut rotation
It may often present in childhood with intestinal obstruction and midgut volvulus [1]
We report a patient with intestinal malrotation and colorectal cancer who had undergone laparoscopic surgery
Summary
Intestinal malrotation is a congenital anatomical anomaly resulting from abnormal midgut rotation. Many cases occur during childhood and present with intestinal obstruction and midgut volvulus. We report a case of intestinal malrotation, and colorectal cancer operated laparoscopically. The diagnosis was appendiceal cancer with nonrotation-type intestinal malrotation. The right-side colon was not fixed to the retroperitoneum, and the right-side colon could be extracted out of the abdominal cavity through the umbilical wound with only adhesive dissection, and mesenteric and lymph node dissection can be performed outside the body. DISCUSSION: Appendiceal cancer with intestinal malrotation is managed with laparoscopic surgery because this method is safe and minimally invasive. CONCLUSION: The laparoscopic approach may be safer and less invasive than laparotomy, and extracorporeal lymph node dissection is safe and reliable for patients with intestinal malrotation
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