Two Cases of Intestinal Malrotation Following Rectal Carcinoma

Katsuyuki Kunieda, Masahiko Kawai, Bun Sano, Atsushi Watanabe, Shigeyuki Takemura, Shigetoyo Saji, Hiroo Goth¹⁾, Kuniyasu Shimokawa²⁾

Second Department of Surgery, Gifu University School of Medicine
¹⁾Department of Radiology, Gifu University School of Medicine
²⁾Department of Laboratory Medicine, Gifu University School of Medicine

We reported two cases of non-rotation of the intestine following rectal carcinoma. Case 1: A 57-year-old woman with anal pain and bleeding consulted a doctor. Rectal tumor was diagnosed by digital examination and she was admitted to our hospital. A barium enema revealed a type 2 rectal carcinoma with non-rotation of the intestine. At laparotomy, the small intestine found to be located on the right side and the large intestine on the left, yielding a diagnosis of non-rotation. She underwent rectal amputation by the abdominoperineal approach with D₃ lymphadenectomy. The tumor was a 6.2×3.8 cm type 2 rectal carcinoma, and was diagnosed as adenosquamous carcinoma of stage I. She has been healthy for the 9 years since the operation. Case 2: A 62-year-old woman with bloody stools consulted our hospital. After a diagnosis of rectal carcinoma at the Ra portion and non-rotation of the intestine, she underwent low anterior resection with D₃ lymphadenectomy. The resected specimen revealed a 52×47 mm semicircular type 2 rectal carcinoma which was histologically diagnosed as moderately differentiated adenocarcinoma of stage IIIa. Both patients underwent prophylactic appendectomy. Intestinal malrotation has the possibility to make diagnosis and treatment of the following diseases difficult, so we must always take into account this condition.

Key words
intestinal malrotation, nonrotation, rectal carcinoma

Reprint requests
Katsuyuki Kunieda Second Department of Surgery, Gifu University School of Medicine
40 Tsukasamachi, Gifu, 500-8076 JAPAN

Accepted
January 14, 1998

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