Volvulus of the Small Intestine in adults with intestinal malrotation: case report

Abstract

Introduction: The volvulus of the small intestine with intestinal malrotation is a rare disease when occuring in adults, though, a surgeon’s ignorance of this diagnosis can result in potentially fatal extensive small intestinal necrosis. Presentation of case: Here, we present the case of a 57years old woman admitted and operated for a volvulus of the small intestine with intestinal malrotation after radiographic and pre-operative confirmation, whom follow up was unmarked. Discussion: The usual mechanism of obstruction in the volvulus of the small intestine with intestinal malrotation is adhesive compression of the duodenum and volvulus of the small intestine, this condition is the result of an arrest in the normal counterclockwise rotation of the cecum from the left lower quadrant to the right upper quadrant. Pre-operative diagnosis not always an easy task but the abdominal CT-scan is with a great help mainly by identifying the "WHIRL-WIND" sign. The Ladd procedure, consisting of division of Ladd’s bands, widening of the mesentery, and incidental appendectomy, is considered the worldwide standard up til now. Conclusion: This condition is rare and can be diagnosed mainly by CT-scan, however,the surgical management worldwide standard is the Ladd's procedure which can be led by laparotomy or laparoscopy and results in great outcome.