Department of Digestive and General Surgery, Department of Surgery C, University Hospital Center Ibn Sina, Rabat, Morocco.
Department of Digestive and General Surgery, Department of Surgery A, Lucien Hussel Hospital Center, Vienne, France.
Pan Afr Med J. 2024 Jan 26;47:34. doi: 10.11604/pamj.2024.47.34.36435. eCollection 2024.
Malrotation of the gut is a congenital anomaly of foetal intestinal rotation and it's principally discovered in early childhood as acute intestinal obstruction. This condition is veritably rare and constantly silent in adults. Intestinal malrotation in adults is frequently asymptomatic and is diagnosed as a casual finding during a radiological examination performed for other reasons. Infrequently, it can be diagnosed in adults, associated with an acute abdomen. Adult patients rarely present with acute midgut volvulus or internal hernias caused by Ladd's bands. We present a case of an admitted 18-year-old female with a small bowel obstruction due to an intestinal volvulus complicating intestinal malrotation in the presence of Ladd's band. Laparotomic Ladd's procedure was performed successfully with division of Ladd's band, adhesiolysis, appendicectomy, and reorientation of the small bowel on the right and the cecum and colon on the left of the abdominal cavity; the postoperative evolution was favorable. Although it is a rare pathology, it should be kept in mind in cases of patients presenting small bowel obstruction.
肠旋转不良是一种胎儿肠旋转异常的先天性畸形,主要在儿童早期发现为急性肠梗阻。这种情况在成人中非常罕见,而且通常无症状。成人肠旋转不良常常无症状,是在因其他原因进行放射学检查时偶然发现的。偶尔,它也可能在成人中诊断出来,与急性腹痛有关。成人患者很少出现由 Ladd 束引起的急性中肠扭转或内疝。我们报告了一例 18 岁女性患者,因存在 Ladd 束而并发肠旋转不良导致小肠扭转,出现小肠梗阻。成功地进行了剖腹 Ladd 手术,包括 Ladd 束的切开、粘连松解、阑尾切除术以及将小肠重新定位到腹部右侧,将盲肠和结肠重新定位到左侧;术后恢复良好。尽管这是一种罕见的病理,但在出现小肠梗阻的患者中应予以注意。