An Adult Case of Intestinal Malrotation Concomitant with Intestinal Obstruction due to Internal Hernia

Kan Handa, Hirohisa Harada, Shinji Ogawa, Michio Sato and Nobutoshi Ando

Department of Surgery, Tokyo Dental College Ichikawa General Hospital

We report a case of intestinal malrotation concomitant with intestinal obstruction due to an internal hernia. A 65-year-old woman admitted for right lateroabdominal pain and vomiting and diagnosed with intestinal obstruction was found in upper GI contrast imaging and abdominal computed tomography to have intestinal malrotation concomitant with idiopathic internal hernia. Laparoscopy showed the hernia orifice to be located in an abnormal intramembranous adhesion between the inferior hepatic border and the peritoneum on the back wall. Incarcerated small intestinal loops were easily repositioned and the orifice was sufficiently expanded. The small intestine located on the right side and the large intestine on the left yielded a diagnosis of nonrotation. Laparoscopy proved very useful both in diagnosis and radical cure.

Key words
adult intestinal malrotation, internal hernia

Reprint requests
Kan Handa Department of Surgery, Keio University School of Medicine
35 Shinanomachi, Shinjuku-ku, 160-8582 JAPAN

Accepted
April 27, 2005

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