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Malrotation of midgut in adults, an unsuspected and neglected condition—An analysis of 64 consensus confirmed cases

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Abstract

Introduction

Malrotation of midgut is considered to be a condition of childhood. This study evaluated malrotation in adults with recurrent abdominal pain (RAP).

Methods

Sixty-four consensus-confirmed cases of intestinal malrotation were reviewed. The diagnosis was based on radiological criteria, and the consensus was arrived at by at least three of the five authors in any individual case.

Results

Abnormal duodenojejunal junction (DJJ) was a consensus finding in 64 cases referred for RAP. Most were in their fourth decade of life, and 12 were beyond 60 years. Besides RAP, intolerance to food was the next common symptom. Acute intestinal obstruction was seen in 16. Forty-two of 64 patients consented for surgery. Ladd’s procedure was the commonest. All patients who underwent surgery were symptom free except for two, of which, one had liver cyst and the other had hernia. Of those who refused surgery (22), all had continued symptoms and 10 patients took alternative therapies. On follow up of initially unwilling patients (for surgery) with abnormal DJJ, only eight consented for surgery; three underwent open Ladd’s procedure, and one had laparoscopic Ladd’s done.

Conclusion

Malrotation is not uncommon as a cause of RAP in adults.

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Authors and Affiliations

  1. Deccan College of Medical Sciences, DMRL X Road, Santosh Nagar, Kanchan Bagh, Hyderabad, 500 058, India

    G. Raghavendra Prasad, J. V. Subba Rao, Humera Fatima, Hameed Mohd. Shareef & Asif Shah

  2. Kamineni Institute of Medical Sciences, Central Bank Colony, L B Nagar, Hyderabad, 500 074, India

    G. Satyanarayana

Authors
  1. G. Raghavendra Prasad
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  2. J. V. Subba Rao
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  3. Humera Fatima
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  4. Hameed Mohd. Shareef
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  5. Asif Shah
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  6. G. Satyanarayana
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Corresponding author

Correspondence to G. Raghavendra Prasad.

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Conflict of interest

GRP, JVSR., HF, MMS, AS, and GS declare that they have no conflict of interest.

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The study was performed in a manner to confirm with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed policy concerning informed consent as shown in Springer.com

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Prasad, G.R., Rao, J.V.S., Fatima, H. et al. Malrotation of midgut in adults, an unsuspected and neglected condition—An analysis of 64 consensus confirmed cases. Indian J Gastroenterol 34, 426–430 (2015). https://doi.org/10.1007/s12664-015-0596-x

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  • DOI: https://doi.org/10.1007/s12664-015-0596-x

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