Late presentation of midgut malrotation with obstruction in a child

Abstract

Midgut malrotation is an anomaly of intestinal rotation that occurs during embryology and usually presents during neonatal period. Symptoms are vague as presentation is delayed whilst some can be identified incidentally during adulthood. Herein we report of a 6-year-old girl who presented with food intolerance, abdominal pain and failure to gain weight. CT-scan confirmed midgut malrotation and was successfully managed by open Ladd's procedure. • Midgut malrotation is a congenital anomaly that usually presents in the neonatal period. • Symptoms are unspecific in older children and sometimes asymptomatic in others. • Midgut malrotation has a high risk of bowel ischaemia due to compression of the SMA. • CT-scan with contrast is diagnostic tool of choice and shows “whirlpool” sign. • Mainstay management is surgery (Ladd's procedure) with promising outcome.