Abstract
A 50-year-old man was admitted to our hospital with lower abdominal pain and vomitus. He complained of oppressive pain in the lower abdomen. Blood examination showed an elevated inflammation reaction. Abdominal CT showed that the superior mesenteric artery was running along the right dorsal side of the superior mesenteric vein and that most of the small intestine was located at the right side of the vertebra. Accordingly, it was suspected that he was suffering from intestinal malrotation. Furthermore, he was suspected to have colon volvulus, because the ascending colon was dilated with indications of a bird’s beak sign and whirl like appearance in the center of the abdomen. We therefore performed an emergency laparotomy, suspecting strangulated intestinal obstruction. Intraoperative findings were in accordance with the preoperative CT findings. We diagnosed the case as a malrotation of the non-rotation type. In addition, a ligament was detected between the cecum and retroperitoneum. We then diagnosed the case as volvulus because a 180-degree counterclockwise torsion could be found in the ileocecal region along the ligament’s axis. Ileocecal resection was carried out. The postoperative course was satisfactory without any complications. Although the occurrence of a cecal volvulus along with malrotation of the intestine is rare, an emergency operation may be required in cases where necrosis of the intestine is suspected. Consequently, when intestinal malrotation is found at the time of a medical examination of an acute abdominal malfunction, prompt medical or surgical treatment is essential.
