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Case Reports in Surgery
Volume 2017, Article ID 4809406, 3 pages
Case Report

Malrotation Induced Small Intestine Ischemia in an Adolescent

Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey

Correspondence should be addressed to Karadeniz Erdem; rt.ude.inuata@zinedarak.medre

Received 1 April 2017; Accepted 7 June 2017; Published 31 July 2017

Academic Editor: Tahsin Colak

Copyright © 2017 Karadeniz Erdem and Atamanalp Selçuk Sabri. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Intestinal malrotation occurs if midgut does not complete or partially completes its 270° counter-clockwise rotation around the superior mesenteric artery during embryologic life. In general, it frequently manifests with vomiting due to duodenal obstruction and volvulus in the initial months of life, and it is very rare to manifest in the adulthood. A 20-year-old male patient who had severe abdominal pain, nausea, vomiting, and distention for one day was evaluated at the emergency department. On abdominal tomography “swirling appearance of structures around the superior mesenteric artery” was reported. CT appearance was considered compatible with a rotational anomaly. Emergency surgery was planned for the patient. In laparotomy, it was observed that an approximately 100 cm long small intestine segment was rotated around a band (Ladd) and ischemia was developed in this segment due to rotation of its mesentery. The rotation of the small intestinal mesentery was corrected by opening the bands. After the warm application to the intestinal mesenteric ischemia for a while, the color and the peristalsis of the intestines became normal. The patient was discharged on postoperative day 2 with suggestions.