A Case of Malrotation of the Intestinal Following Gastric Cancer

Takao Horiba, Masaji Yamauchi, Eisaku Sato, Tatsuaki Nakashio and shigehiro Kure

Department of Surgery, Tokai Central Hospital

We report a case of intestinal malrotation following gastric cancer. A 73-year-old man with general fitigue was found in gastroscopy, upper gastrointestinal series, barium enema examination, and abdominal computed tomography to have intestinal malrotation seen for gastric cancer. At laparotomy, the small intestine was located on the right and the large intestine on the left, yielding a diagnosis of nonrotation. Distal gastrectomy with D2 dissection and Billroth I reconstruction were conducted without intestinal fixation for intestinal malrotation. Intestinal malrotation has been diagnosed in 72 children and adults in Japan between 1993 and 1999. In children, 13 of 14 cases (93%), were observed with abdominal symptoms due to embryonal anomalies including malrotation. In middle and old age, 24 of 40 cases (60%) were detected during investigation for intestinal tumors, appendicitis, and etc. Among 8 cases of intestinal malrotation with gastrectomy reported from 1983 to 2000, 2 cases of intestinal malrotation induced midgut volvulus postoperatively.

Key words
intestinal malrotation, gastric cancer, SMV rotation sign

Reprint requests
Takao Horiba Department of Surgery. Tokai Central Hospital 4-6-2 Soharahigashishima-cho, Kakamigahara, 504-8601 JAPAN

Accepted
June 25, 2002

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