Assenza M, Reali C, Valesini L, Marenga G, Bartolucci P, Rossi D, Modini C
Emergency Department, Policlinico "Umberto I" of Rome,"Sapienza" University of Rome, Italy.
Clin Ter. 2015;166(2):e105-7. doi: 10.7417/CT.2015.1829.
The aim of the article is showing a particular case of midgut nonrotation. It is a congenital defect of the bowel development, during which fails the rotation of 270° around the vascular pedicle. This anomaly causes a different intestinal arrangement: the small bowel is located in the right side of abdominal cavity while the large bowel is situated in the left side. We present a case of acute appendicitis and abscess treated successfully with urgent surgical intervention in a patient completely asymptomatic for nonrotation. Nonrotation may lead to acute symptoms, vague abdominal pain or may remain asymptomatic throughout all life and be discovered only accidentally. Radiological exams and laparoscopy can help to make a correct diagnosis. A conservative treatment could be preferred in asymptomatic patients and Ladd's surgical procedure should be performed in selected cases.
本文旨在展示中肠不旋转的一个特殊病例。它是肠道发育的一种先天性缺陷，在此期间，肠道未能围绕血管蒂旋转270°。这种异常导致不同的肠道排列：小肠位于腹腔右侧，而大肠位于左侧。我们报告一例急性阑尾炎和脓肿患者，该患者完全没有中肠不旋转的症状，经紧急手术干预成功治疗。中肠不旋转可能导致急性症状、腹部隐痛，也可能终生无症状，仅偶然被发现。放射学检查和腹腔镜检查有助于做出正确诊断。无症状患者可首选保守治疗，在某些特定病例中应进行Ladd手术。
