Aregawi Alazar Berhe, Geremew Teketel Tadesse, Legese Abel Tesfaye, Bahru Teferi Tesfaye
Department of Surgery, Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.
Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.
Int J Surg Case Rep. 2025 Feb;127:110848. doi: 10.1016/j.ijscr.2025.110848. Epub 2025 Jan 6.
Intestinal malrotation is a congenital disorder resulting from the failure of the normal embryologic fetal sequence of bowel rotation and fixation. Adult midgut malrotation is extremely uncommon, with incidence estimates ranging from 0.0001 % to 0.19 %. In adults, there is a slight female predominance. Mid gut volvulus leads to obstruction and warrants surgical intervention. This case is significant because there are few case reports around the world.
An 18-year-old Ethiopian man presented with cramping abdominal pain that worsened over a one-month period. He had been experiencing pain since early childhood, which worsened a year before his presentation. CT scan of the abdomen was consistent with malrotation and was treated surgically.
Diagnosing intestinal malrotation in adults is difficult due to the variety and nonspecificity of the symptoms. Delays in diagnosis may lead to acute complications and poorer operative outcomes.
This case report will raise awareness among physicians about the possibility of this rare condition affecting adults. As a result, when a patient presents with chronic gastrointestinal symptoms, they have a high index of suspicion and inform them that an abdominal CT should be performed in these cases, and surgery is the primary treatment option.
肠旋转不良是一种先天性疾病,由肠道正常胚胎期旋转和固定顺序失败所致。成人中肠旋转不良极为罕见,发病率估计在0.0001%至0.19%之间。在成人中,女性略占优势。中肠扭转会导致梗阻,需要手术干预。该病例具有重要意义,因为全球范围内此类病例报告较少。
一名18岁埃塞俄比亚男性因腹部绞痛就诊,疼痛在一个月内逐渐加重。他自幼就有疼痛症状,此次就诊前一年疼痛加剧。腹部CT扫描结果符合旋转不良,遂接受手术治疗。
由于成人肠旋转不良症状多样且不具特异性,诊断较为困难。诊断延迟可能导致急性并发症和较差的手术预后。
本病例报告将提高医生对这种罕见疾病影响成人可能性的认识。因此,当患者出现慢性胃肠道症状时,医生应高度怀疑,并告知患者在这些情况下应进行腹部CT检查,手术是主要治疗选择。