PERSISTENT BOWEL MALROTATION IN AN ADULT WITH PREVIOUS SURGERY: CASE REPORT AND SURGICAL CONSIDERATIONS

Abstract

Intestinal malrotation (IBM) is a rare congenital anomaly in adults, with an incidence of 0.2%, resulting from incomplete or absent rotation of the midgut during embryonic development. Its manifestations in adulthood are insidious and nonspecific, including pain, abdominal distension, and malnutrition, and it causes complications such as volvulus, ischemia, and intestinal obstruction. This case highlights the importance of considering this condition in adults with persistent gastrointestinal symptoms. Diagnosis is based on clinical findings and imaging tests such as abdominal tomography (CT) or magnetic resonance imaging (MRI), with contrast-enhanced radiography of the upper gastrointestinal tract being the gold standard. In this case, abdominal MRI revealed persistent malrotation even after prior surgery, highlighting the complexity of treatment and differential diagnosis. Ladd's procedure is the gold standard, and the choice of the open approach, despite the benefits of laparoscopy, was justified by the complexity of the condition, reinforcing the need for individualized surgical management based on patient characteristics and intraoperative findings. This report highlights the need for awareness among healthcare professionals about MRI, its potential complications, diagnosis, and treatment, allowing for earlier detection of similar cases and more timely management, improving clinical outcomes and patient quality of life.