Diagnostic Delay in Intestinal Malrotation Presenting During Adolescence
1Rivers State University Teaching Hospital, Port Harcourt.
Abstract
Introduction: Intestinal malrotation refers to any variation in the rotation and fixation of the gastrointestinal tract during development. While most cases present in infancy with acute obstructive symptoms, a significant number remain undiagnosed until later in childhood or adulthood, often exhibiting vague or nonspecific symptoms that complicate timely diagnosis and management.
Case Report: A 10-year-old boy presented with recurrent abdominal pain of 5 years’ duration, recent onset of bilious vomiting, and constipation. Barium meal and follow-through imaging revealed a markedly distended stomach and proximal duodenum that ended blindly. Exploratory laparotomy confirmed intestinal malrotation with midgut torsion, and Ladd’s procedure was performed. The patient recovered uneventfully and has remained asymptomatic on follow-up.
Conclusion: This case emphasizes the importance of considering intestinal malrotation as a differential diagnosis in older children with recurrent abdominal pain. Early recognition may prevent catastrophic complications such as bowel ischemia, chronic midgut volvulus, malnutrition, and short bowel syndrome.
Data Availability
All data used in this study is available on request
Author Biographies
Chuka Ugwunne
Rivers State University Teaching Hospital, Port Harcourt.
Department of Surgery
Stephen Chigozie Anaero-Nweke
Rivers State University Teaching Hospital, Port Harcourt.
Department of Surgery
Mary-Jane Anthony Udoh
Rivers State University Teaching Hospital, Port Harcourt.
Department of surgery
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Published in Vol. 8 No. 1 (2025): African Journal of Tropical Medicine and Biomedical Research, June 2025.
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