A Case of Acute Appendicitis with Intestinal Malrotation in a Child Treated by Single-incision Laparoscopic Assisted Appendectomy

Abstract

An 11-year-old boy was admitted to our hospital because of lower abdominal pain. Contrast-enhanced abdominal CT scan revealed that the superior mesenteric vein was located to the left of the superior mesenteric artery, the ascending colon and the transverse colon had sifted to the left side of the abdomen, and the small intestine, to the right side of the abdomen. The swollen appendix was detected in the mid-lower abdomen. We diagnosed the case as acute appendicitis with intestinal malrotation, and performed emergency single-incision laparoscopic surgery under general anesthesia using two 5 mm ports inserted through a single 2-cm umbilicus incision. No abnormalities such as pedicle or Ladd ligament were found. The appendix was easily extracted from the intra-abdominal cavity through the small incision site of the umbilicus, and appendectomy was performed under direct vision. Single-incision laparoscopic assisted appendectomy was useful for acute appendicitis with intestinal malrotation.