Abstract
A 61-year-old man visited our hospital because of fatigue and jaundice. An abdominal CT scan revealed dilatation of the intrahepatic and common bile ducts and wall thickening with enhancement effect located at the Vater's ampulla. The CT scan also demonstrated that the superior mesenteric artery (SMA) ran in the right side of the superior mesenteric vein (SMV), the entire small intestine was located at the right side of the abdominal cavity, whereas the ascending colon at the left side of the SMA. Ampullary cancer accompanied by malrotation was diagnosed, and pancreaticoduodenectomy (PD) was performed with reconstruction by the modified Child's procedure. Since the transverse portion of the duodenum was not recognized and the ligament of Treitz was absent, nonrotation type intestinal malrotation was diagnosed. The postoperative course was uneventful and the patient was discharged from our hospital on 13th day after the surgery. We herein report a rare case of ampullary cancer combined with adult intestinal malrotation treated by PD.
