Intestinal nonrotation

Case contributed by Badis Al Harbawi
Diagnosis almost certain

Presentation

Right lower abdominal pain

Patient Data

Age: 15 years
Gender: Female
ct

CT scanogram showed the colon predominantly located on the left side of the abdomen and small bowel on the right. No dilatation of the bowel loops. 

ct

The small intestine is situated in the right hemiabdomen, while the large bowel, including the ileocecal junction and ascending colon located on the left side.

There is an inverse relation of the SMA and SMV.

No signs of bowel obstruction or midgut volvulus.

The appendix is seen in the mid-lower abdomen and appears normal.

Multiple small mesenteric lymph nodes.

The liver, spleen, pancreas, adrenals and both kidneys appear normal.

Minimal pelvic free fluid is seen in the pelvis mostly likely physiological.

Case Discussion

The appearances, in this case, are compatible with nonrotation of the bowel, which is a congenital anomaly and considered as a subtype of intestinal malrotation.

It is usually asymptomatic, but it can predispose to midgut volvulus.

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