Intestinal malrotation

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

Fever with mild abdominal pain for the last few days.

Patient Data

Age: 35 years
Gender: Female
ultrasound

There is an inverse relationship of the superior mesenteric artery-vein in the epigastric region. Small bowel loops replace the colon on the right side of the abdomen. The ileocecal junction and the appendix are located in the mid-line in the infraumbilical region. There is no wall thickening of the terminal ileum/ cecum/ appendix. The duodenum does not cross midline under the superior mesenteric artery.

Case Discussion

A female presented with a history of fever for the last few days. The terminal ileum was not localized in the right iliac fossa which was a hint for intestinal malrotation. Further evaluation revealed that the duodenum doe not cross the midline which favors intestinal malrotation. There were other signs of intestinal malrotation; an inverse relationship of the superior mesenteric artery and vein in the epigastric region, small bowel replacing the colon in the right side of the abdomen.

There was no recurrent abdominal pain in the past.

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