Jia XH, Kong S, Gao XX, Cong BC, Zheng CN. Intestinal malrotation complicated with gastric cancer: A case report. World J Clin Cases 2024; 12(1): 210-216 [PMID: 38292641 DOI: 10.12998/wjcc.v12.i1.210]
Corresponding Author of This Article
Chun-Ning Zheng, MD, PhD, Professor, Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Huaiyin District, Jinan 250000, Shandong Province, China. yinzx123@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiang-Hao Jia, School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
Shuai Kong, Xin-Xin Gao, Bi-Cong Cong, Chun-Ning Zheng, Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Author contributions: Jia XH drafted, reviewed, and revised the manuscript; Zheng CN was the primary physician during the patient’s hospital stay; Kong S, Gao XX, and Cong BC provided the images; and all authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Ning Zheng, MD, PhD, Professor, Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Huaiyin District, Jinan 250000, Shandong Province, China. yinzx123@163.com
Received: October 31, 2023 Peer-review started: October 31, 2023 First decision: November 9, 2023 Revised: November 22, 2023 Accepted: December 15, 2023 Article in press: December 15, 2023 Published online: January 6, 2024
Abstract
BACKGROUND
Intestinal malrotation is a congenital defect of embryonic development caused by various teratogenic factors. In this condition, the intestinal tube, along with the superior mesenteric artery serving as the axis for the counterclockwise movement, is incomplete or abnormally rotated due to incomplete attachment of the mesentery and abnormal intestinal tube position. Such a case is usually asymptomatic and thus difficult to detect. Therefore, similar variant malformations are only found during an operation required for other abdominal diseases.
CASE SUMMARY
An elderly male patient was admitted to the hospital due to gastric cancer. An abdominal computed tomography (CT) scan with contrast revealed that the ascending and descending colon were parallel on the right side of the abdominal cavity, while the sigmoid colon extended into the right iliac fossa, allowing the diagnosis of congenital midgut malrotation. Following thorough preoperative preparation, the patient underwent laparoscopic radical gastrectomy to treat his gastric cancer. Intraoperatively, an exploration of the abdominal cavity uncovered the absence of the transverse colon. The distal colon at the hepatic flexure, along with the ascending colon, extended into the right iliac fossa, where it continued as the sigmoid colon. As planned, the laparoscopic radical gastrectomy was performed, and the patient was discharged from the hospital 7 d after the surgery.
CONCLUSION
Asymptomatic intestinal malrotation is best detected by CT, requiring no treatment but possibly interfering with the treatment of other diseases.
Core Tip: Intestinal malrotation is a congenital defect that often goes unnoticed, lacks clinical symptoms, and can complicate the management of other abdominal conditions. Surgeons must recognize the potential presence of intestinal malrotation to adjust their approach effectively during abdominal surgery.
