Skip to main content
Log in

Intestinal Malrotation

A Rare but Important Cause of Bowel Obstruction in Adults

  • Published:
Diseases of the Colon & Rectum


PURPOSE: Complications of intestinal malrotation are familiar to pediatric surgeons but are rarely encountered by those caring strictly for adults. The aim of this study was to review our experience with disorders of intestinal rotation in adult patients and to emphasize the clinical presentation, radiographic features, and results of surgical treatment. METHODS: Ten adult patients (mean age, 42 (range, 22–73) years) with complications of intestinal malrotation were identified by review of department records. Clinical presentation, operative treatment, and outcome were recorded. RESULTS: Nine patients presented with obstructive symptoms (five chronic and four acute). A diagnosis of malrotation was made preoperatively in all cases by a small-bowel contrast study or CT scan. Patients were treated by laparotomy with adhesiolysis (4 cases including one paraduodenal hernia and two midgut volvuli), Ladd’s procedure (4 cases), or duodenopexy and cecopexy (1 case). One patient presented with an acute abdomen and was found to have appendicitis. There was no mortality. Two patients developed complications (wound infection and ileus). Two patients had recurrent episodes of small-bowel obstruction with a mean follow-up of 30 (range, 2–69) months and one required reoperation. CONCLUSIONS: Complications of intestinal rotation can occur in adult patients and may present with chronic or acute symptoms. Prompt recognition and surgical treatment usually lead to a successful outcome. The diagnosis of intestinal malrotation should be considered in any adult patient with signs and symptoms of small-bowel obstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. WB Kiesewetter JW Smith (1958) ArticleTitleMalrotation of midgut in infancy and childhood AMA Arch Surg 77 483–491 Occurrence Handle1:STN:280:CyaD3M7nsFc%3D Occurrence Handle13582407

    CAS  PubMed  Google Scholar 

  2. EJ Balthazar (1976) ArticleTitleIntestinal malrotation in adults. Roentgenographic assessment with emphasis on isolated complete and partial nonrotations AJR Am J Roentgenol 126 358–367 Occurrence Handle1:STN:280:CSmC3svhtFE%3D

    CAS  Google Scholar 

  3. HW Gilbert CP Armstrong MH Thompson (1990) ArticleTitleThe presentation of malrotation of the intestine in adults Ann R Coll Surg Engl 72 239–242 Occurrence Handle1:STN:280:By%2BA2czitFw%3D Occurrence Handle2382946

    CAS  PubMed  Google Scholar 

  4. RS Cathcart SuffixIII B Williamson HB Gregorie SuffixJr PF Glasow (1981) ArticleTitleSurgical treatment of midgut nonrotation in the adult patient Surg Gynecol Obstet 152 207–210 Occurrence Handle7209763

    PubMed  Google Scholar 

  5. HB Devlin RS Williams JW Pierce (1968) ArticleTitlePresentation of midgut malrotation in adults Br Med J 30 803–807

    Google Scholar 

  6. NM Dott (1923) ArticleTitleAnomalies of intestinal rotation Br J Surg 11 251–286

    Google Scholar 

  7. WH Snyder SuffixJr L Chaffin (1954) ArticleTitleEmbryology and pathology of intestinal tract Ann Surg 140 368–379 Occurrence Handle13198074

    PubMed  Google Scholar 

  8. CE Gardner D Hart (1934) ArticleTitleAnomolies of intestinal rotation as a cause of intestinal obstruction Arch Surg 29 942–379

    Google Scholar 

  9. T Fukuya BP Brown CC Lu (1993) ArticleTitleMidgut volvulus as a complication of intestinal malrotation in adults Dig Dis Sci 38 438–434 Occurrence Handle1:STN:280:ByyC1crksFI%3D Occurrence Handle8444073

    CAS  PubMed  Google Scholar 

  10. AB Paul DM Dean (1990) ArticleTitleComputed tomography in volvulus of the midgut Br J Radiol 63 893–894 Occurrence Handle1:STN:280:By6D2s%2Fhsl0%3D Occurrence Handle2252985

    CAS  PubMed  Google Scholar 

  11. DM Nichols DK Li (1983) ArticleTitleSuperior mesenteric vein rotation, a CT sign of midgut malrotation AJR Am J Roentgenol 141 707–708 Occurrence Handle1:STN:280:BiyA3crjslA%3D Occurrence Handle6604422

    CAS  PubMed  Google Scholar 

  12. PA Gaines AJ Saunders D Drake (1987) ArticleTitleMidgut malrotation diagnosed by ultrasound Clin Radiol 38 51–53 Occurrence Handle1:STN:280:BiiC3s3ht1Y%3D Occurrence Handle3545635

    CAS  PubMed  Google Scholar 

  13. WE Ladd (1932) ArticleTitleCongenital obstruction of the duodenum in children N Engl J Med 206 277–53

    Google Scholar 

Download references

Author information

Authors and Affiliations


About this article

Cite this article

Dietz, D.W., Walsh, R.M., Grundfest-Broniatowski, S. et al. Intestinal Malrotation. Dis Colon Rectum 45, 1381–1386 (2002).

Download citation

  • Issue Date:

  • DOI: