title: Duodenal Obstruction Caused by Acute Appendicitis with Intestinal Malrotation in a Child.
abstract: BACKGROUND
  In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children.
  
  
  METHODS
  We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. A diagnosis could not be made by computed tomography, ultrasonography, or endoscopy. We observed a dilated stomach and malrotation in laparotomy. The caecum was in the right upper quadrant, and an inflamed appendix was located in the subhepatic region. After the appendectomy, the cecum was mobilized and fixed in the right lower quadrant.
  
  
  CONCLUSIONS
  In children with intestinal malrotation, acute appendicitis can present as duodenal obstruction without abdominal pain, and standard imaging methods can miss the correct diagnosis.
authors: Department of Pediatric Surgery, Erzincan University, Medical School, Erzincan, Turkey.
authors: Şenol
authors: Ş
authors: Biçer
authors: Department of General Surgery, Konya State Hospital, Konya, Turkey.
authors: Ali
authors: A
authors: Çelik
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000150:complications*; D004380:Duodenal Obstruction / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D008297:Male