Successful laparoscopic Ladd's procedure and appendectomy for intestinal malrotation with appendicitis.
We successfully performed a laparoscopic Ladd's procedure and an appendectomy in a 15-year-old girl with intestinal malrotation and appendicitis. She had tenderness and rebound pain in the umbilicus and left lower abdominal quadrant. Blood analysis revealed a moderate inflammatory response. Enhanced computerized tomography (CT) scanning revealed a whirl-like pattern and a superior mesentric vein (SMV) rotation sign in the mesentry of the small intestine. A swollen appendix was seen just below the umbilicus. An upper gastrointestinal (GI) radiological series confirmed agenesis of Treitz's arch. The patient was diagnosed as having a nonrotation type of malformation accompanied by acute appendicitis. She underwent a laparoscopic Ladd's procedure, an appendectomy, peritoneal lavage, and drainage. The technique for this procedure and its effectiveness are briefly discussed.
Tsumura
H
H
Department of Surgery, Hiroshima Municipal Funairi Hospital, 14-11 Funairisaiwai-cho, Naka-ku, Hiroshima-shi, 730-0844 Japan. tuntun1234@hotmail.com
Ichikawa
T
T
Kagawa
T
T
Nishihara
M
M
D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D010535:Laparoscopy; D011859:Radiography