Intestinal Malrotation with Midgut Volvulus leading to Small Bowel Obstruction in a Young Adult: A Case Report

  • Junaid Zia Hashmi Post Graduate Resident, Nishter Hospital Multan, Pakistan
  • Talha Kareem Post Graduate Resident, Nishter Hospital Multan, Pakistan
  • Masood ur Rauf Khan Hiraj Professor, Head of Department, Surgical Unit IV, Nishter Hospital Multan, Pakistan
Keywords: Intestinal malrotation, Midgut volvulus, Right hemicolectomy, Small bowel obstruction


The developing intestine rotates around the superior mesenteric vessels during physiological herniation from 6th to 10th weeks of embryogenesis. Intestinal malrotation leading to midgut volvulus and small bowel obstruction is a rare condition. Patients who develop this condition usually present in the first year of their life. Intestinal malrotation is characterized by right sided duodenojejunal junction, caecum in left iliac fossa and a narrow mesentery. Ladd’s procedure is the treatment of choice which is done to restore the normal anatomy. We report the case of an 18-year-old male patient, who presented with intestinal malrotation in emergency department of Nishtar Hospital, Multan. It is an uncommon age for presentation of this anomaly. The patient had fecal peritonitis due to caecal perforation. He underwent Ladd’s procedure in which ileocolostomy was made after right hemicolectomy. The patient had an uneventful recovery after the surgery and had no complaints on follow up visit one week after the discharge.

Case Reports