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Case Report
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| Small bowel obstruction in an adult patient with situs ambiguous and mid gut malrotation | ||||||
| Shwe Phyo Han1, Jonathan Grassby2 | ||||||
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1MBBS, MS, Surgical Registrar, Department of Surgery, Dubbo Base Hospital, Dubbo, NSW, Australia.
2MBBS, FRACS, Consultant Surgeon, Department of Surgery, Dubbo Base Hospital, Dubbo, NSW, Australia. | ||||||
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| How to cite this article |
| Han SP, Grassby J. Small bowel obstruction in an adult patient with situs ambiguous and mid gut malrotation. Int J Case Rep Imag 2016;7(5):303–305. |
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Abstract
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Introduction:
Situs ambiguous or heterotaxy syndrome is defined as the abnormal positioning of internal viscera relative to the normal. Diagnosis in adult is extremely rare as 90–99% of the patients have severe cardiac abnormalities and die by the age of five years.
Case Report: A 32-year-old male was presented to hospital with sudden onset abdominal pain, abdominal distension, vomiting and absolute constipation for one day. There was no other medical problems. Examination was also unremarkable. Abdomen was distended and generally tender. Per rectal examination showed empty rectum. Blood tests were unremarkable. Computed tomography scan of abdomen and pelvis showed closed loop mid to distal small bowel obstruction with small bowel wall thickening. Malrotation of the bowel was noted. It also showed that stomach and spleen were on the right side of the body. Emergency laparotomy showed small bowel volvulus and spleen, stomach, duodenojejunal flexure and small bowel were in the right side of the abdomen and colon was in the left side of the abdomen. Ileocecal valve was noted in the left side of the abdomen. Adhesiolysis and derotation of the affected small bowel were performed. Appendicectomy was performed due to its location in left lower quadrant. The patient was discharged from the hospital four days after the operation. Conclusion: There is no case report on adult situs ambiguous presented with acute intestinal obstruction before. We report this case for extremely rare occurrence of situs ambiguous with mid gut malrotation presented with small bowel obstruction in the adult age group. | |
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Keywords:
Abdominal pain, Mid gut malrotation, Situs ambiguous, Small bowel obstruction, Vomiting
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Author Contributions
Shwe Phyo Han – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Jonathan Grassby – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Shwe Phyo Han 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. |
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