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Fig. 2 A computed tomography scan shows not only a huge dilated duodenum but also a 'whirling' of the mesenteric vessel trunk (arrow). Fig. 3 A dense fibrotic check details adhesion of the mesocolon and the ascending colon had developed due to recurrent tension (arrow). Fig. 4 This photograph shows the duodenum (D), the ascending colon (AC), the cecum (C), and the appendix (A). The relative positions (V) of the duodenum, ascending colon, and engorged mesenteric vessels before the complete dissection between the duodenum (D) ... DISCUSSION Intestinal malrotation originates from failure of the normal rotation and fixation of the midgut during the embryonic period. Dott [4] described an intestinal malrotation through embryology, and Ladd [5] reported a corrective procedure for treating an intestinal malrotation. Even after these studies, an intestinal malrotation in an adult was not a disease entity that was familiar to general surgeons because usually surgeons do not fully understand congenital anomalies. Moreover, an intestinal malrotation is not common in adults, and its symptoms are vague and various, ranging from abdominal pain to emesis, nausea, diarrhea, etc. Consequently, some patients undergo an incorrect surgical treatment (gastroileostomy after gastric resection), TRIB1 and some are treated as having a functional or psychiatric disease [6,7]. However, in recent days, much knowledge has been accumulated on intestinal malrotations in adults, and the results of many studies have been reported. Especially, the remarkable development of the CT scan allows proper diagnosis and management of this disease. Nehra and Goldstein [2] described different symptoms of an intestinal malrotation and the incidence of midgut volvulus among three age-related groupings of 170 find more patients presenting with an intestinal malrotation. According to that study, the most common symptom was abdominal pain in the adult group (>18 years of age), as was emesis in the infant group (
