Renal malrotation

Case contributed by Dr Craig Hacking

Presentation

Abdominal pain and diarrhoea

Patient Data

Age: 55 years
Gender: Female
CT

There is a single loop of small bowel in the lower abdomen is mildly distended and fluid-filled. There is an abrupt transition from normal to dilated calibre at both proximal and distal ends however no obstructing mass is identified. The transition point are remote from each other. Minor fat stranding is present in the mesentery of this loop. No small bowel wall thickening. Large bowel is unremarkable. No free gas.

The appendix has been removed previously. The liver, abdomen, spleen, pancreas, adrenals and kidneys are normal. Incidental malrotation of the right kidney. No enlarged abdominal lymph nodes seen. No free fluid or gas is demonstrated. No suspicious soft tissue or bony lesion demonstrated. No evidence of an inguinal, femoral or periumbilical hernia.

A small 8mm calcified subserosal fibroid seen.

Lung bases are clear. Bones are unremarkable.

Conclusion

Solitary loop of small bowel dilatation in the lower abdomen suggests an early low grade obstruction.

Case Discussion

The low grade small bowel obstuction clear with conservative managment.

Good example of the horizontal axis of a malrotated kidney.

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Case information

rID: 37718
Case created: 19th Jun 2015
Last edited: 26th Sep 2017
Inclusion in quiz mode: Included

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