Author(s): G. Sridhar1, B. Venkata Rao2, R. L. Chaitanya3, Satish Chaitanya K4, Ravindra Babu5
Intestinal Malrotation in adults is twisting of the intestines that lead to mal positioning of the bowels and malfixation of the mesentery, blocking the digestive tract and preventing the proper passage of food. Midgut malrotation is a congenital anomaly in the embryological development of the foetal intestinal rotation. It has been estimated that it affects approximately 1 in 500 live births.  Symptomatic malrotation is estimated to occur in 1 in 6000 live births.  Traditionally, intestinal malrotation has been considered primarily a disease of infancy with infrequent occurrence beyond the first year of life. Adult midgut malrotation is very rare and its incidence has been reported to be between 0.0001% and 0.19%. [3,4] Most adult diagnoses of midgut malrotation are made in asymptomatic patients; either on imaging investigations for unrelated conditions or at operations for other pathology. However, there are a small proportion of affected adults who may present with acute or chronic symptoms of intestinal obstruction or intermittent and recurrent abdominal pain. The true diagnosis in this age group is fraught with immense difficulty, especially because the typical presentation is with non-specific symptoms and the fact that adult Surgeons usually have low index of suspicion and may not consider the diagnosis a possibility in the initial evaluation of adult patients with abdominal pain. We report a rare case of an 36 year old patient presented as acute intestinal obstruction due to midgut malrotation.