Reverse intestinal rotation in an adult resulting in concomitant small and large bowel obstruction

A computed tomography (CT) scan of the abdomen and pelvis with oral and intravenous contrast revealed a dilated common bile duct, a ''whirlpool'' sign with torsion of the proximal small bowel, and superior mesenteric vein around the SMA with the transverse colon coursing posteriorly to the SMA (Fig. 1). [...]adults with malrotation who never presented with obstruction in childhood have spent their entire lives with this abnormal anatomy, which can be the cause of many subtle, chronic and insidious complaints, ranging from constipation and mild crampy abdominal pain such as in the case we presented to malabsorption.3 Oftentimes, this leads to a misdiagnosis of IBS.