Midgut Volvulus Secondary to Intestinal Malrotation in Adult Male: A Case Report and Mini Review

S. N. Jatal *

Jatal Hospital and Research Centre, Latur, India.

Sudhir Jatal

Jatal Hospital and Research Centre, Latur, Tata Hospital, Mumbai, India.

Supriya Jatal

MGM Hospital & College, Navi Mumbai, India.

Ganesh Swami

V.D. Govt. Medical College, Latur, India.

*Author to whom correspondence should be addressed.


Intestinal malrotation is a congenital anomaly that occurs due to abnormal rotation and fixation of the intestine when it returns to the abdominal cavity during fatal development. There have been only 92 documented cases of this condition in medical literature. The incidence of malrotation is approximately 1 in 6,000 live births. Most malrotation cases, about 60-80%, become evident in the first month of life, with 90% being diagnosed within the first year. Adult presentations of malrotation are exceedingly rare, accounting for only 0.2 to 0.5% of cases, and among these, only 15% present with midgut volvulus. The incidence of midgut malrotation in adults has been reported to be between 0.00011 and 0.19%. Most diagnoses of midgut malrotation in adults occur in asymptomatic patients, often through imaging investigations or incidental findings during surgeries for other medical issues.

Diagnosis of midgut volvulus is primarily established through various methods, with CT abdomen being the most common (67%), followed by ultrasonography (15%), and during exploratory laparotomy (18%). It's important to note that midgut volvulus is associated with a high risk of bowel ischemia and necrosis, as it affects the blood supply to the intestines through the mesenteric artery, resulting in a significant 5% mortality rate.

We are reporting an unusual case involving a 20-year-old male who was found to have midgut volvulus affecting his jejunum and small bowel. This condition was a consequence of congenital malrotation of the bowel. The patient underwent an exploratory laparotomy, during which the volvulus was corrected by detorsion, inter-mesenteric bands adhesiolysis, and an appendectomy was performed.

Keywords: Intestinal malrotation, midgut volvulus, ladd’s procedure

How to Cite

Jatal , S. N., Jatal , S., Jatal , S., & Swami , G. (2023). Midgut Volvulus Secondary to Intestinal Malrotation in Adult Male: A Case Report and Mini Review. Asian Journal of Research in Surgery, 6(2), 303–309. Retrieved from https://journalajrs.com/index.php/AJRS/article/view/171


William A Butterworth, James W Butterworth. An adult presentation of midgut volvulus secondary to intestinal malrotation: A case report and literature review, International Journal of Surgery Case Reports Available:https://doi.org/10.1016/j.ijscr.2018.07.007.

Emanuwa OF, Ayantunde AA, Davies TW. Midgut malrotation first presenting as acute bowel obstruction in adulthood: A case report and literature review. World J Emerg Surg. 2011;6(22). Available:https://doi.org/10.1186/1749-7922-6-22

Prasan Kumar Hota, D Abhishek, V Bhaskar, Adult midgut malrotation with ladd’s band: A rare case report with review of literatures, Bali Medical Journal (Bali Med. J.). 2014;3(3):137-142. ISSN.2089-1180, E- ISSN.2302-2914.

Torres AM, Ziegler MM. Malrotation of the intestine. World J Surg. 1993 May- Jun; 17(3):326-31. DOI: 10.1007/BF01658699. PMID: 8337878

Ramprasad Rajebhosale, Rajesh Chidambaranath, Cindy Cleto, Dylan Parmar, Najam Husain, Pradeep Thomas, EP.TH.273

Intestinal Malrotation in Adults: A case series and Literature Review, British Journal of Surgery. 2021; 108(Supplement_7):znab309.033 Available:https://doi.org/10.1093/bjs/znab309.033

Ribeiro, Tiago, Greene, Brittany, Bennett, Sean, Msallak, Haytham, Karanicolas, Paul. Variations in intestinal malrotation in adulthood: A case report of midgut volvulus and literature review for the surgeon. International Journal of Surgery Case Reports. 2022;91: 106750. DOI: 10.1016/j.ijscr.2021.106750.

Mohan A, Ansari WA, Gada PB, Dandge SM, Nagwani PD.Intestinal malrotation with midgut volvulus: Associations and role of elective surgery in adults. Int Surg J. 2022;9:1272- 6.

Jarvis J K, Rambhajan A. Adult Intestinal Malrotation in a Non- Paediatric Hospital in Trinidad: A Case Report and Literature Review. Cureus. December 26, 2020; 12(12):e12305. DOI: 10.7759/cureus.12305

Bastiaan W Haaka, Sander T Bodewitz, Caroline F Kuijper, Louise M de Widt-Levert. Intestinal malrotation and volvulus in adult life, B.W. Haak et al. / International Journal of Surgery Case Reports. 2014; 5:259–261.

Rohit Kapoor, Narinder Singh, Shubh Kirti b¥and Abhishek Sharma, Management of Sixteen Year Old Male with Intestinal Malrotation by Ladd’s Procedure: A Case Report and Review of Literature, Asian Journal of Case Reports in Surgery. 2022;5(1):188-192. Article no.AJCRS.87995.