Philippine Journal of Surgical Specialties Vol. 78, No. 1, January-June 2023, pp 20-25

Malrotation in the Adult, a Forgotten Etiology of Partial Gut Obstruction: A Report of Two Cases

Author(s): Ma. Corazon Cabanilla-Manuntag, MD; Jan Paolo M. Cruz, MD; Sofia Isabel T. Manlubatan, MD and Marc Paul J. Lopez, MD, FPCS

Ninety percent of cases of malrotation have shown signs and symptoms of intestinal obstruction by the first year of life. It is thus an often-overlooked etiology in adult patients. Evidence-based recommendations are also limited because of the paucity of cases. This paper discusses the two cases of malrotation from diagnosis to surgical management at a tertiary academic hospital. Both are previously well adult male patients with virgin abdomen who presented with vomiting and signs of intestinal obstruction. During medical decompression, CT scan with triple contrast clinched the diagnosis of malrotation for which Ladd’s procedure was done, with no operative complications. The authors’ experience and previous literature support early decompression, imaging, and surgery for all cases of malrotation regardless of severity of symptoms.

Key words: intestinal malrotation, bowel obstruction, Ladd’s procedure