Korean J Gastroenterol.  2010 Apr;55(4):252-255. 10.4166/kjg.2010.55.4.252.

Nonrotation of the Prearterial Segment of Midgut Presenting as Duodenal Obstruction in a 60-Year-Old Man

• Park HN
• Park JJ
• Cheon JH
• Hyung WJ
• Cho SH
• Kim KH
• Kim TI
• Kim WH

• KMID: 1792776
• DOI: http://doi.org/10.4166/kjg.2010.55.4.252

Abstract

Intestinal malrotation is a developmental anomaly resulting from embryologic failure of fixation and rotation of the gut and predisposed to midgut vovulus and small bowel obstruction. Although various forms of malrotation anomalies in the gut can occur, nonrotation of prearterial segment with the initial symptomatic presentation at advanced age has been rarely reported. Here, we report a case of nonrotation of the prearterial segment of the midgut presenting with duodenal obstruction in a 60-year-old man. To our best knowledge, this is the first case reported about nonrotation of prearterial segment of the midgut in Korea.

Keyword

Intestinal malrotation; Nonrotation; Duodenal obstruction; Midgut

MeSH Terms

Diagnosis, Differential
Duodenal Obstruction/*diagnosis/surgery
Humans
Intestinal Volvulus/*diagnosis/radiography
Intestine, Small/*abnormalities/embryology/pathology
Male
Middle Aged
Rotation
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. (A, B) Esophagogastro-duodenoscopic examination showed discrete red streaky superficial erosions longer than 5 mm, at esoph-agogastric junction just above Z- line and large amount of bile sta-sis in the stomach.

• 

  Fig. 2. Computed-tomography showed markedly distended duode-num, proximal jejunum and abnormally located superior mesenteric vein (arrow).

• 

  Fig. 3. Upper gastrointestinal series showed abnormal right-sided uodenojejunal flexure and segments of luminal narrowing of je-num owing to an extrinsic process.

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  Fig. 4. Microscopic appearance of the adhesion band revealed fi-bromuscular tissue (H&E stain, ×100).

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