Intestinal malrotation - incidental in older patient
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No acute pathology.
Typical findings of intestinal malrotation: SMA right of SMV, 3rd portion of the duodenum never crosses midline, small bowel on in right abdomen, colon in mid-left abdomen, cecum/IC valve in pelvis. Appendix starts in pelvis and courses into the right lower quadrant.
Incidental findings on a flank pain study in an older patient. Although not often the case with malrotation, this particular patient never had any issues with malrotation throughout her life.
Appendix terminates in the right lower quadrant, so if this patient did have appendicitis, a relatively typical presentation of lower abdominal or pelvic pain would be expected.