A CASE OF VOLVULUS OF THE ASCENDING COLON WITH INTESTINAL MALROTATION IN AN ADULT

Intestinal malrotation is a kind of congenital anomaly due to abnormal rotation and non-fixation of midgut in the fetus period. We report a case of volvulus of the ascending colon with intestinal malrotation in an adult. An 83-year-old woman was seen at the hospital because of abdominal pain and vomiting lasting for 3 days. Radiographic studies showed ovally dilated colon in the upper left side abdomen and a diagnosis of intestinal obstruction was made. Conservative treatment using an ileus tube was unsuccessful, and so the patient underwent an operation. Upon laparotomy, we noted that intestinal malrotation was 180 degree rotation type of midgut and non-fixed ascending colon became volvulus. Right colectomy was performed for the dilated ascending colon volvulus which had ischemic change and necrosis. We considered that she had the problem of extensive colon due to chronic constipation and multidrug therapy might have caused increased colonic mobility ending up in this volvulus.