A Rare Case of Intestinal Malrotation in an adult Female and its Management

Abstract

Intestinal malrotation is a rare congenital anomaly in adults and is more frequent over age 60. We report a 60-year-old woman with a long history of gastrointestinal symptoms who presented with sudden abdominal pain and constipation. CT imaging revealed malrotation without volvulus. A multidisciplinary team opted for a laparoscopic Ladd’s procedure. During surgery, we found Ladd’s bands compressing the duodenum and divided them. We straightened the duodenum, widened the mesentery and removed the appendix. The patient left the hospital with no complications. Clinicians should consider malrotation when adults report chronic, vague abdominal symptoms. Although surgeons often use Ladd’s procedure in children, they rarely apply it in older patients. This case describes one of the first laparoscopic Ladd’s procedures in a patient over 60. It shows that a minimally invasive approach can work in carefully chosen adult patients without bowel obstruction. The findings support further study of this technique in selected older patient populations.