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Case Report
Intestinal duplication in an adult presenting as acute small bowel obstruction with malrotation and volvulus: Case report and updated review of the literature
1 Attending Surgeon, Department of General Surgery, IMED Levante Hospital, Calle Dr. Santiago Ramón y Cajal, 7, 03503 Benidorm, Alicante, Spain
2 Medical Student, Rosalind Franklin University of Medicine & Sciences, Chicago Medical School, 3333 N Green Bay Rd, North Chicago, IL 60064, USA
Address correspondence to:
Marie Nunez Duarte
Chicago Medical School, Class of 2025, 3333 N Green Bay Rd, North Chicago, IL 60064,
USA
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Article ID: 100145Z12MG2024
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Gomez ME, Duarte MN, Silver R, Dieter A. Intestinal duplication in an adult presenting as acute small bowel obstruction with malrotation and volvulus: Case report and updated review of the literature. J Case Rep Images Surg 2024;10(2):26–31.ABSTRACT
Introduction: Intestinal malrotation and duplication are rare congenital anomalies that typically present in childhood, but can also occur in adults. Adult presentations are often associated with acute obstructive symptoms, and complications like volvulus and ischemia can rapidly lead to life-threatening outcomes. Early recognition and intervention are essential for ensuring favorable outcomes.
Case Report: We report an interesting case of intestinal duplication and malrotation in a 49-year-old male who presented with acute abdominal pain, bilious vomiting, and bloating. Imaging revealed a twisted intestinal segment, initially mimicking a large Meckel’s diverticulum. Surgical exploration uncovered an ischemic segment of ileum with complex torsion and gangrene, necessitating resection and anastomosis.
Conclusion: This case highlights the rarity of intestinal malrotation presenting in adulthood, and the severe complications that can result. The rapid progression to ischemia and necrosis emphasizes the need for timely surgical intervention. While Ladd’s procedure is often the treatment of choice, it is not feasible when bowel viability is compromised, as in this case. Adult presentations of intestinal duplication with volvulus are rare, but should be considered in patients with acute obstructive symptoms.
Keywords: Adult congenital anomalies, Intestinal duplication, Intestinal malrotation, Ischemic bowel, Small bowel obstruction, Surgical resection, Volvulus
SUPPORTING INFORMATION
Author Contributions
Maria Eugenia Gomez - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marie Nunez Duarte - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rebecca Silver - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alayna Dieter - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Maria Eugenia Gomez et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
