Linyi People's Hospital, Jinzhou Medical University, Linyi 276000, China.
Department of Gastrointestinal Surgery, Linyi People's Hospital, Linyi 276000, China.
Medicine (Baltimore). 2024 Feb 23;103(8):e37249. doi: 10.1097/MD.0000000000037249.
Intestinal malrotation is an infrequent congenital anomaly primarily observed in neonates, and adult-onset cases are exceedingly rare. Studies on adult congenital intestinal malrotation are limited.
A case with congenital intestinal malrotation is reported in our study. The clinical data were collected and the treatment process and effect were evaluated.
A 45-year-old female who had been experiencing vomiting for over 40 years was admitted to our hospital. According to the result of CT scan, intestinal volvulus accompanied by bowel obstruction was suspected. Then laparoscopic examination was applied to the patient and was ultimately diagnosed with adult congenital intestinal malrotation. We performed Ladd's procedure combined with gastrojejunostomy and Braun anastomosis. The patient recovered well and was successfully discharged from the hospital on the 13th day after surgery. After a 6-month follow-up, the symptom of vomiting was significantly alleviated and body weight was gained for 10 kg. She was very satisfied with the treatment.
Adult congenital intestinal malrotation is a rare disease that is often misdiagnosed owing to nonspecific clinical manifestations. Therefore, awareness about this condition should be enhanced. Surgery remains the cornerstone of treatment for this disease. Combining gastrojejunostomy and Braun anastomosis with the traditional Ladd procedure can optimize surgical outcomes.
肠旋转不良是一种罕见的先天性畸形，主要发生在新生儿中，成人发病极为罕见。关于成人先天性肠旋转不良的研究较少。
我们报道了 1 例成人先天性肠旋转不良患者。收集了患者的临床资料，评估了治疗过程和效果。
患者为 45 岁女性，反复呕吐 40 余年，入院后 CT 检查提示肠扭转并肠梗阻可能。行腹腔镜检查，最终诊断为成人先天性肠旋转不良。行 Ladd 手术+胃空肠吻合+Braun 吻合术。患者术后恢复良好，术后 13 天顺利出院。术后 6 个月随访，呕吐症状明显缓解，体重增加 10kg，患者对治疗效果非常满意。
成人先天性肠旋转不良是一种罕见疾病，由于其临床表现不典型，常易误诊。因此，应提高对该病的认识。手术仍然是治疗该病的基石。胃空肠吻合+Braun 吻合联合传统 Ladd 术式可以优化手术效果。
