title: Left-Sided Appendicitis in an Elderly Patient with Midgut Malrotation.
abstract: Appendicitis is a common surgical abdominal disease with various presentations. Its diagnosis may be obscured by asymptomatic congenital anatomical anomalies like midgut malrotation. Midgut malrotation is a rare fetal anomaly resulting from incomplete or failure of midgut rotation and fixation. It is mostly presented with bowel obstruction or volvulus in early life. Presentation in adult is rare. Here, we report an elderly patient presented with left lower abdominal pain and urinary tract infection. Abdominal computed tomography revealed left-sided appendicitis with non-rotational-type midgut malrotation. Clinicians should bear in mind the possibility of underlying midgut malrotation, as appendicitis could be the first presentation of this rare congenital condition.
authors.affiliation: Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600 Taiwan.
authors.forename: Pei Wen
authors.initials: PW
authors.lastname: Chuang
authors.affiliation: Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600 Taiwan.
authors.forename: Bo-Ming
authors.initials: BM
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600 Taiwan.
authors.forename: Chung Hsien
authors.initials: CH
authors.lastname: Liu
authors.affiliation: Department of Pathology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan ; Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Chien-Chin
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600 Taiwan.
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Tsai
keywords: Acute appendicitis; Intestinal malrotation; Left-sided appendicitis; Midgut malrotation