A case of midgut malrotation presenting as subacute intestinal obstruction in an adult

Case presentation A 68 year old male presented with nausea and abdominal bloating of three months duration. His bowel habits were normal. Patient was previously well. Clinical examination was unremarkable except for a right sided uncomplicated direct inguinal hernia. Patient underwent upper gastrointestinal endoscopy (UGIE) twice after optimal preparation. Food particles were seen in the pyloric region. Scope could not be negotiated beyond the distal second part of the duodenum. Ultrasound scan demonstrated dilated 1st and 2nd part of the duodenum with to and fro movements. Upper gastrointestinal contrast studies demonstrated midgut malrotation (Figure 1).