Incidentally discovered intestinal malrotation during evaluation for blunt abdominal trauma: A case report

• Published in: International journal of surgery case reports Vol. 116; p. 109430
• Main Authors: Devkota, Shishir, Luitel, Prajjwol, Paudel, Sujan, Neupane, Nischal, Dev, Santosh, Kansakar, Prasan Bir Singh
• Format: Report
• Language: English
• Published: 01-03-2024
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109430

INTRODUCTION AND IMPORTANCEIntestinal malrotation is a congenital abnormality predominantly diagnosed in children, with only a few cases reported in adults. Patients may be incidentally identified during unrelated surgical procedures or postmortem examinations. It is crucial to promptly recognize this condition to prevent severe complications such as bowel ischemia and potential fatality.CASE PRESENTATIONA 40-year-old male presented to the Emergency Department after a child jumped on his abdomen with complaints of acute left upper quadrant abdominal pain progressing to be generalized. Examination showed pallor, abdominal tenderness without guarding or rigidity, and intact bowel sounds. Preoperative diagnostic tools revealed intestinal malrotation confirmed during the laparotomy, prompting the performance of Ladd's procedure to address the malrotation.CLINICAL DISCUSSIONDisruption in the normal embryological development of bowel is the cause of intestinal malrotation. The role of additional surgery especially in patients with asymptomatic disease related to malrotation is debated.CONCLUSIONIntestinal malrotation is rare in adults and often found incidentally during evaluation for unrelated medical conditions. Timely identification and surgical intervention usually result in positive outcomes. Our case underscores the incidental discovery of malrotation during the evaluation of blunt abdominal trauma, treated with Ladd's procedure. This is particularly significant due to geographical constraints associated with the patient's rural origin, as untreated malrotation could lead to complications in future occurrences.