A Case of Diagnosed Preoperatively Midgut Volvulus with Intestinal Malrotation in an Adult

A 24-year-old man admitted for abdominal distension and pain was found in upper gastrointestinal studies to have an abnormally positioned duodenojejunal junction and proximal jejunal loops. Barium enema showed the colon to be located on the left side of the abdomen. Abdominal computed tomography (CT) showed a whirl-like pattern consistent with soft tissue encircling the superior mesenteric artery, yielding a diagnosis of midgut volvulus with intestinal malrotation. Laparotomy showed the midgut to be twisted 900 degrees clockwise with nonrotation, necessitating Ladd.s procedure and appendectomy. Although the midgut volvulus is rare in adults, preoperative diagnosis may be made when the possibility of this disease is kept in mind.