Open AccessMidgut malrotation with volvulus discovered at an emergency caesarean section for placental abruption
Author(s) -
Kofi Tawiah Mensah,
Raphael Kwarase,
Stephenson Laari,
William N. A. Thompson
Publication year - 2021
Publication title -
ghana medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.294
H-Index - 22
eISSN - 2616-163X
pISSN - 0016-9560
DOI - 10.4314/gmj.v55i1.14
Subject(s) - medicine , laparotomy , gangrene , volvulus , surgery , abdominal pain , placental abruption , caesarean section , surgical emergency , pregnancy , obstetrics , general surgery , gestation , biology , genetics
Adult midgut malrotation with volvulus (AMMV) is an uncommon presentation which may be found incidentally during abdominal radiologic investigations or at laparotomy. We report a case of AMMV and small bowel gangrene in a 35-year-old Gravida four, Para three at 39 weeks, 4 days gestation who presented with a short history of worsening abdominal pain, repeated vomiting and abdominal wall guarding. Emergency caesarean section performed on account of a suspected placental abruption incidentally revealed a long segment of non-viable small intestine. Subsequent midline laparotomy disclosed a midgut malrotation with volvulus and bowel gangrene. This resulted in a 4.6m resection of non-viable small bowel with Ladd’s procedure. The patient developed moderate symptoms of short bowel syndrome in the post-operative period which was successfully managed non-operatively. This case report represents a rare diagnosis, in the West-African sub-region, of an adult midgut malrotation with volvulus mimicking a third trimester obstetric emergency.