A Case of Diagnosed Preoperatively Midgut Volvulus with Intestinal Malrotation in an Adult

Hisanori Kashizuka, Tomoyoshi Takayama, Tatsuma Imura, Kiyoshi Kamada, Junji Okayama, Hiroyuki Kuge, Takeshi Ueda, Daisuke Hokuto and Mitsutoshi Tatsumi

Department of Surgery, Hoshigaoka Koseinenkin Hospital

A 24-year-old man admitted for abdominal distension and pain was found in upper gastrointestinal studies to have an abnormally positioned duodenojejunal junction and proximal jejunal loops. Barium enema showed the colon to be located on the left side of the abdomen. Abdominal computed tomography (CT) showed a whirl-like pattern consistent with soft tissue encircling the superior mesenteric artery, yielding a diagnosis of midgut volvulus with intestinal malrotation. Laparotomy showed the midgut to be twisted 900 degrees clockwise with nonrotation, necessitating Ladd's procedure and appendectomy. Although the midgut volvulus is rare in adults, preoperative diagnosis may be made when the possibility of this disease is kept in mind.

Key words
malrotation, volvulus

Reprint requests
Hisanori Kashizuka Department of Surgery, Hoshigaoka Koseinenkin Hospital
4-8-1 Hoshigaoka, Hirakata, 573-8511 JAPAN

Accepted
April 23, 2008

To read the PDF file you will need Abobe Reader installed on your computer.