A Case of Malrotation of a Paraduodenal Hernia with Ascending Colon Carcinoma

Abstract

A 54-year-old woman was admitted with a type 2 cancer in the ascending colon. Abdominal CT showed the ascending colon in the center of the lower abdomen, the small intestine in the right upper quadrant, and semi-circumferential wall thickening of the ascending colon. 3D-CT angiography showed that the superior mesenteric artery (SMA) was to the right of the superior mesenteric vein (SMV), and running ventral to the SMV. The patient underwent right hemicolectomy with D2 lymph node dissection. At operation, a normal Treitz's ligament was found, with no Ladd's ligament, and the small intestine passed through the root of the mesentery behind the transverse colon. Therefore, the diagnosis of a paraduodenal hernia with intestinal malrotation was made. In Japan, only 42 cases of colon cancer with intestinal malrotation have been reported to date ; herein, we review these cases and present our first case with paraduodenal hernia type of intestinal malrotation.