J Korean Soc Radiol.  2011 Apr;64(4):365-368. 10.3348/jksr.2011.64.4.365.

Multidetector CT Findings of Retroarterial Reversed Intestinal Rotation in an Adult: A Case Report

• Sung JK
• Ku YM
• Chae HS
• Whang IY
• Lee SL

• KMID: 1443540
• DOI: http://doi.org/10.3348/jksr.2011.64.4.365

Abstract

Intestinal malrotation is an uncommon cause of abdominal pain in adults. More so, reversed intestinal rotation is one of the least common malrotation anomalies. A few cases of reversed intestinal rotation have been reported only in surgical and internal medicine literatures. To the best of our knowledge, MDCT findings concerning reversed intestinal rotation had never been reported. We present a 38-year-old man with retroarterial reversed intestinal rotation with MDCT findings.

MeSH Terms

Abdominal Pain
Adult
Colon
Humans
Internal Medicine
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A-D. Serial axial images of a contrast-enhanced CT of a 38-year-old man with reversed rotation. SMV (thick arrow) lies to the left of SMA (thin arrow) in the first image (A), and SMV wraps around SMA clockwise on consecutive images (B-D). It is noted that the duodenum (dotted lines in A and B) cross from the right to left anterior to SMA and SMV. Images at the level of lower pole of the kidneys (Cand D) demonstrate that the distended transverse colon (T) is sandwiched between the superior mesenteric vessels and the aorta. E-G. The sagittal (F) reformatted image more clearly depicted the relationship between the superior mesenteric vessels (thin and thick arrows) and the transverse colon (T). A tissue transition projection (F) from CT colonoscopy discloses focal narrowing of transverse colon (open arrows) and the abnormal location of the cecum. The overhead image after double-contrast barium enema (G) is exactly coincidental with the image of CT colonoscopy, which shows focal extrinsic compression of the transverse colon and resultant narrowing of the involved segment (open arrows). The cecum, appendix, and ileocecal valve are located in the right upper quadrant of the abdomen.

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