2023 Volume 32 Issue 2 Pages 147-150
Intestinal malrotation refers to the impaired rotation of the intestinal tract and its fixation to the peritoneum. Pediatric patients are the most commonly affected population, while adult patients are rarely affected. Few reports exist on abdominal aortic aneurysm replacement in patients with intestinal malrotation. However, the surgical strategy remains unestablished. This study reports the case of a 69-year-old man, who was diagnosed with intestinal malrotation during gastric cancer surgery and underwent abdominal aortic aneurysm replacement via a transperitoneal approach. The intestinal malrotation was challenging to evaluate on computed tomography. Due to the patient’s age, abdominal aortic aneurysm replacement was deemed appropriate. Intraoperatively, the small intestine was located in the right abdomen, while the colon was in the left abdomen. The duodenum, mesentery, and ascending colon were not fixed to the peritoneum. The intestine was mobilized to the right upper quadrant and abdominal aortic aneurysm replacement was performed to address the infrarenal abdominal aortic aneurysm. The small intestine was placed in the right abdomen, while the colon was placed in the left abdomen to prevent postoperative midgut volvulus. Based on this case, patients with abdominal aortic aneurysm and a concomitant intestinal malrotation may nevertheless undergo surgery safely and the important procedures for the performance are how to approach the aorta and bowels’ positioning when closing abdomen.
