Malrotation Syndrome: A Clinical Case of Intestinal Twist in a 50-Year-Old Patient
https://doi.org/10.17238/2072-3180-2024-1-20-24
Abstract
Introduction. Malrotation syndrome is exceptionally rare in the adult population, predominantly manifesting clinically in infants within the first month of life. The most common form of malrotation is Ladd's syndrome, with occasional delayed presentations into adulthood. Consequently, diagnosing and timely surgically treating such patients pose a complex challenge. In instances of delayed diagnosis and treatment, there is a significantly elevated risk of developing strangulated intestinal obstruction or intestinal infarction, leading to potentially lethal complications.
Description. This article presents a clinical case of a 50-year-old female with Ladd's syndrome admitted to the surgical ward in a state of complications, presenting as acute strangulated intestinal obstruction. The article outlines the management approach taken in this clinical scenario, detailing a successful two-stage surgical intervention. The first stage involved emergency resection of the pathological segment of the small intestine and the distal portion of the cecum, with the creation of an ileostomy and transverse colostomy. The second stage, planned four months later, encompassed a reconstructive-restorative operation aimed at restoring the integrity of the intestinal passage.
Results. Systematic collection of complaints, disease history, accurate interpretation of pre-hospital and in-hospital laboratory and instrumental study results facilitated a correct diagnosis and the implementation of an effective surgical intervention. The patient exhibited favorable clinical outcomes in the remote postoperative period.
About the Authors
E. A. Toneev
Ulyanovsk State University
Russian Federation
Russian Federation
Toneev Evgeniy Aleksandrovich – PhD, assistant, Department of Faculty Surgery, Faculty of Medicine named after T.Z. Biktimirova, Institute of Medicine, Ecology and Physical Culture
432000, Ulyanovsk, L. Tolstoy, 42
E. A. Keshyan
The State Budgetary Institution "City Clinical Hospital №15 named after O.M. Filatova DZM" Moscow ; Russian National Research Medical University named after. N.I. Pirogov
Russian Federation
Russian Federation
Keshyan Eric Ashotovich – candidate of medical sciences, doctor of the surgical department, Assistant, Department of Hospital Surgery 1
Moscow, Veshnyakovskaya str., 23, 111539
117997, Russia, Moscow, st. Ostrovityanova, 1
D. S. Kostyaev
The State Budgetary Institution "City Clinical Hospital №15 named after O.M. Filatova DZM" Moscow
Russian Federation
Russian Federation
Kostyaev Dmitriy Sergeevich – doctor of the surgical department
111539, Moscow, Veshnyakovskaya str., 23
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Review
For citations:
Toneev E.A., Keshyan E.A., Kostyaev D.S. Malrotation Syndrome: A Clinical Case of Intestinal Twist in a 50-Year-Old Patient. Moscow Surgical Journal. 2024;(1):20-24. (In Russ.) https://doi.org/10.17238/2072-3180-2024-1-20-24
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