Presentation
Right iliac fossa pain, associated with 1 episode of vomiting and nausea. No fever. Tenderness on deep palpation. CRP 20.
Patient Data
There is evidence of midgut non-rotation in the form of small bowel loops occupying the right quadrant of the abdomen and colonic loops in the left quadrant.
There is reversal of the SMA and SMV axis. Duodenum is not crossing the midline.
No acute complication. No volvulus.
No features of appendicitis. The appendix appears normal.
Case Discussion
Intestinal non-rotation is a form of malrotation, a developmental anomaly where the small bowel occupies the right peritoneal cavity and the colon is displaced to the left.
It is usually found incidentally, but it predisposes to midgut volvulus.