Rare presentation of congenital gut malrotation as adult cecal volvulus

Abstract

Incomplete or faulty rotation and fixation of the gut during 5th–11th week of the fetal life results in intestinal malrotation. Cecal volvulus is a rare (1%–1.5%) cause of intestinal obstructions in adults. However, it accounts up to 25%–40% of all volvuluses involving the colon. Cecal volvulus due to malrotation presenting as an intestinal obstruction in an adult is very rare, and only few cases are reported in the literature. We present a case report of a 33-year-old adult male who presented to the emergency with a 2-day history of pain abdomen and vomiting with no significant past history. Per abdomen examination revealed a tender lump in the right paraumblical region. The diagnosis of intestinal obstruction was made on clinical and X-ray features. Emergency laparotomy was done. However, to our surprise, we found that the patient is having malrotated gut with cecal volvulus with the features of intestinal obstruction. The cecal volvulus was carefully de-torted, and right hemicolectomy with hand-sewn end-to-side ileotransverse anastomosis was done. Postoperatively, the patient behaved well and was discharged on the 8th postoperative day.