title: Pancreaticoduodenectomy in the setting of intestinal malrotation.
abstract: Malrotation is an intestinal gestational disorder which not only affects the positioning of the midgut, but also its vascular supply. While this is generally thought of as a pediatric surgical condition, it can have significant implications for adult surgeries as well. Herein we present a patient with asymptomatic nonrotation of the midgut with a concomitant pancreatic adenocarcinoma. The authors review the modifications necessary to perform a pancreaticoduodenectomy in a nonrotated patient. The review includes a caution and emphasis on an understanding of the vascular anatomic variants.
authors.affiliation: Department of Surgery, Tripler Army Medical Center, Honolulu, HI, USA. timothy.plackett@us.army.mil
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Plackett
authors.forename: Ryan
authors.initials: R
authors.lastname: Takamori
authors.forename: Mark
authors.initials: M
authors.lastname: Izawa
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D004065:Digestive System Abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*