Abstract

REYES BALSEIRO, Evelio Salvador; CASTELLO GONZALEZ, Mauro  and  ARMAS PEREZ, Bárbaro Agustín. Duodenal occlusion by intestinal malrotation in the adult. AMC [online]. 2012, vol.16, n.3, pp.318-327. ISSN 1025-0255.

Introduction: although it may occur in asymptomatic way, almost all patients with intestinal malrotation present clinical manifestations in early stages of life, either with a picture of duodenal obstruction by Ladd´s bands or with a volvulus of the midgut. The appearance in adulthood is uncommon; frequently the consequences of late diagnosis are often serious. Case report: a 62-year-old male patient, with epigastralgia of 40 years of evolution, mediate and sporadic postprandial gastrobiliary vomiting. The gastroduodenal radiological series showed duodenal dilation, delayed évidement and location of the duodenojejunal flexure and thin ansae to the right of the spine. Chronic mechanical occlusion of upper small intestine by intestinal malrotation and Ladd´s bands was diagnosed. Laparotomy evidenced duodenal dilation, adhesive bands from the ascending colon, which caused an extrinsic occlusion. The patient had a postoperative abscess of Douglas that was treated and he was discharged from hospital asymptomatic. Conclusions: intestinal malrotation is an infrequent disease in adults, in any of its way of presentation that should be suspected in patients with occlusive or subocclusive intestinal pictures to repetition.

Keywords : DUODENAL OBSTRUCTION; LAPAROTOMY; DUODENOSCOPY; CASE STUDIES.

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