title: Malrotation of the gut harbouring midgut volvulus in an adult with situs inversus totalis: a clinical delay and treatment dilemma.
abstract: A 22-year-old man experiencing infrequent episodes of abdominal pain, distension, non-bilious vomiting and constipation, was diagnosed with malrotation of the gut. He was treated conservatively over the past 10 years. He was referred to our hospital owing to recent aggravation of symptoms. He had no signs of peritonitis. On imaging, malrotation of the gut, with midgut volvolus and situs inversus totalis, was found. Diagnosis was confirmed during laparotomy. A large sac was present to the right of midline. Detorsion of the sac was performed and the sac was opened. The duodenum and caecum were found in the left upper abdomen adherent to the lateral abdominal wall. Adhesiolysis was performed and extrinsic compression at the duodenum relieved. The large bowel was placed on the right side and small bowel was placed on the left. Appendectomy and feeding jejunostomy were performed. Thorough analysis (clinicoradiological) is necessary before considering conservative management in patients known to harbour a congenital anomaly of the gut.
authors: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Sunil
authors: S
authors: Chumber
authors: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Manjunath Maruti
authors: http://orcid.org/0000-0001-9498-6744
authors: MM
authors: Pol
authors: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Jawed
authors: J
authors: Akhtar
authors: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Madhur
authors: M
authors: Uniyal
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging; D001062:Appendectomy; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging* / Q000601:surgery*; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D007582:Jejunostomy; D007813:Laparotomy; D008297:Male; D012857:Situs Inversus / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult