Midgut Malrotation in an Adult Presenting as an Acute Abdomen

Abstract

Introduction: Midgut malrotation is a rare congenital anomaly in adults that can cause acute abdomen due to bowel obstruction and ischemia. Early diagnosis is challenging but crucial to prevent severe complications.

Case Presentation: A 26-year-old male presented with acute abdominal pain, bilious vomiting, and obstipation. Imaging revealed small bowel obstruction. Emergency surgery showed midgut volvulus with extensive gangrenous bowel requiring resection. Only 30 cm of healthy small bowel remained, and a jejunoileal anastomosis was performed.

Results: Postoperative management included total parenteral nutrition and gradual oral feeding. The patient developed features of short bowel syndrome due to massive bowel loss but was discharged with follow-up care.

Conclusion: Adult midgut malrotation, though rare, should be considered in acute abdomen cases without prior surgery. Prompt diagnosis and surgical intervention are essential to reduce morbidity and mortality.