Wang Qing, Sun Ke, Gong Xiao-Song
Department of General Surgery, Medical Center of Digestive Disease, Zhuzhou Central Hospital, Zhuzhou 412007, Hunan Province, China.
World J Gastrointest Surg. 2025 Jul 27;17(7):106700. doi: 10.4240/wjgs.v17.i7.106700.
Congenital malrotation of the intestine is characterized by an abnormality in intestinal anatomy and mesenteric fixation resulting from disordered rotation of the intestine around the mesenteric artery during embryonic life. This disease can cause intestinal torsion, intestinal obstruction and other acute abdominal symptoms.
A 23-year-old female patient was admitted to our hospital on January 11, 2024, with a history of recurrent periumbilical pain for over 10 years and worsening for 6 months. In this report, the patient was diagnosed with a congenital midgut malrotation with herniation of the jejunum into a malformed omentum in surgery. The patient developed a hernia sac of the omentum adjacent to the duodenum, with the upper jejunum herniating to form an intra-abdominal hernia. During surgery, the jejunum-ileum and ileocecal junction were positioned according to their normal anatomy, and the mesentery root was linearly fixed to the posterior abdominal wall. Ascending colon and right transverse colon were repositioned in their normal anatomical locations. The patient was monitored for more than 1 year post-surgery and recovered well with no signs of abdominal pain or distension.
Congenital midgut reverse transposition is a specific malrotation of the intestine that is often found in adulthood. It is prone to forming intra-abdominal epiploic hernias. Personalized surgical treatment can achieve better results.
先天性肠旋转不良的特征是在胚胎期肠围绕肠系膜动脉旋转紊乱导致肠道解剖结构和肠系膜固定异常。这种疾病可引起肠扭转、肠梗阻等急性腹部症状。
一名23岁女性患者于2024年1月11日入院，有10余年反复脐周疼痛病史，近6个月加重。在本报告中，该患者在手术中被诊断为先天性中肠旋转不良伴空肠疝入畸形网膜。患者在十二指肠旁形成一个网膜疝囊，空肠上段疝出形成腹内疝。手术中，将空肠-回肠和回盲部按正常解剖位置复位，并将肠系膜根部线性固定于后腹壁。升结肠和右横结肠重新定位到正常解剖位置。术后对患者进行了1年多的监测，恢复良好，无腹痛或腹胀迹象。
先天性中肠反向转位是一种特殊的肠旋转不良，常于成年期发现。它易于形成腹内网膜疝。个体化手术治疗可取得更好的效果。
