Surgical management of intestinal malrotation in adults.
OBJECTIVE
The aim of this study was to review our experience with diagnosis and surgical management of intestinal malrotation in adult patients.


METHODS
A retrospective review of the surgical outcome of adults with intestinal malrotation was performed. Twelve patients were observed and treated between July 1996 and July 2006 (4 women and 8 men; the mean age of the patients was 28.5 years). Surgical outcomes, including postoperative complications, deaths, and resolution of preoperative symptoms, were measured.


RESULTS
A diagnosis of malrotation was made preoperatively in five patients by upper gastrointestinal contrast study, barium enema, or computed tomography scan. The anomaly was discovered incidentally at laparotomy in seven patients. All cases were proved to be malrotation intraoperatively. Nine patients underwent laparotomy and three underwent laparoscopic surgery (one converted to an open procedure). Follow-up ranged from 2 months to 118 months. Three patients had complications: one had wound infection, one had delayed gastric emptying, and one developed adhesive ileus. There were only two recurrences detected and one patient with recurrence required reoperation. No one died.


CONCLUSIONS
Intestinal malrotation is a rare but important cause of abdominal pain in adults. It may present with chronic or acute symptoms. Laparotomy and laparoscopy are alternative and feasible techniques with low rates of complications for the treatment of intestinal malrotation in adults.
Fu
Tao
T
Department of General Surgery, Daping Hospital & Field Surgery Institution, The Third Military Medical University, Chongqing, China. michael2foot@yahoo.com.
Tong
Wei Dong
WD
Department of General Surgery, Daping Hospital & Field Surgery Institution, The Third Military Medical University, Chongqing, China.
He
Yu Jun
YJ
Department of General Surgery, Daping Hospital & Field Surgery Institution, The Third Military Medical University, Chongqing, China.
Wen
Ya Yuan
YY
Department of General Surgery, Daping Hospital & Field Surgery Institution, The Third Military Medical University, Chongqing, China.
Luo
Dong Lin
DL
Department of General Surgery, Daping Hospital & Field Surgery Institution, The Third Military Medical University, Chongqing, China.
Liu
Bao Hua
BH
Department of General Surgery, Daping Hospital & Field Surgery Institution, The Third Military Medical University, Chongqing, China.
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007422:Intestines / Q000002:abnormalities* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012399:Rotation; D016896:Treatment Outcome