[Late recognition of intestinal malrotation].
BACKGROUND
Intestinal malrotation is a congenital intestinal abnormality caused by abnormal intestinal rotation during foetal development.


METHODS
We describe a 20-year-old woman with many years' history of abdominal symptoms and eating disorders that were labelled as psychosomatic following repeated and extensive investigations. The diagnosis of malrotation was only made after an emergency laparotomy, with right hemicolectomy for intestinal necrosis.


CONCLUSIONS
The reason that diagnosis was missed in this patient was probably not only because malrotation is accompanied by non-specific symptoms. The cognitive strategies used by doctors to make a diagnosis on the basis of symptoms may also have led to ignoring details that did not fit, and to clinging to earlier diagnoses. Furthermore, eating disorders and gastrointestinal disorders are sometimes difficult to distinguish and are often linked. Even with extra vigilance a misdiagnosis cannot always be avoided.
Universiteit Utrecht.
L
L
Jeung
E J B
EJ
Furnée
H H G
HH
Witjes
C P M
CP
Zwitserlood
J M J
JM
Geesing
J A M
JA
Dorresteijn
D000328:Adult; D003082:Colectomy; D003951:Diagnostic Errors; D004065:Digestive System Abnormalities / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D009336:Necrosis / Q000473:pathology; D055815:Young Adult