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Mid Gut Malrotation, Ladd's Band, Ladd's Procedure
Background: Midgut malrotation is an anomaly of intestinal rotation that occurs during fetal development and usually presents in the neonatal period. It is rare for midgut malrotation to present in adulthood.
Method: We present a case of 15 year old girl presenting with acute abdomen of 15 days duration. Clinical evaluation and investigations revealed features of acute small gut obstruction with peritonitis. Patient underwent exploratory laparotomy which revealed Ladd’s band with midgut malrotation with gangrenous and perforated duodeno-jejunal segment. Derotation with release of band with appendicectomy and resection of gangrenous segment with end to end anastomosis and anatomical repositioning of the bowel was performed.
Results: Complete resolution of symptoms seen in 4 months follow-up. We report this case for the rarity of the case with an unusual presentation of adult midgut malrotation due to Ladd’s band presenting with gangrene of the affected gut with perforation, which was managed successfully.