Adult Midgut Volvulus Secondary to Intestinal Malrotation: A Five Patient Case Series from a Tertiary Care Centre

Abstract

Background: Midgut volvulus secondary to intestinal malrotation is a rare but potentially live threatening conditions in adults. Although most cases present during infancy, delayed presentation in adulthood can occur with acute intestinal obstruction, bowel ischemia or chronic intermittent abdominal symptoms. Objective: To describe the clinical presentation, radiological findings, surgical management and outcomes of adult patients diagnosed with midgut volvulus secondary to intestinal malrotation and to review the current literature. Methods: We retrospectively reviewed five patients diagnosed with midgut volvulus secondary to intestinal malrotation at a tertiary care centre. Clinical presentation, radiological findings, operative management and post-operative outcome were analysed. Case Summary: The patients ranged in age from 14 to 70 years, presenting symptoms included acute abdominal pain, vomiting, abdominal distension and chronic intermittent pain abdomen. Contrast enhanced computed tomography (CECT) demonstrated the characteristic whirlpool sign in all cases. All patients underwent surgical invention with the Ladd’s procedure. All patients survived and had favourable post-operating outcomes