Intestinal Malrotation in Adults. Laparoscopic Ladd's Surgery

Abstract

Ladd's band malrotations are a subtype of embryogenesis abnormalities consisting of fibrous prolongations resulting from anomalous fixation of the mesentery. They extend from a malrotated cecum towards the retroperitoneum and can produce extrinsic compression of the duodenum. In 90% of cases, the clinical presentation occurs within the first year of life as an acute condition consisting of duodenal occlusion or small bowel volvulus with consequent small bowel ischemia or internal hernia. In adulthood, the presentations are less specific. The gold standard methods used for diagnosis are gastroduodenal series and computed tomography. Surgical treatment consists of Ladd's surgery, whose conventional approach was described in 1936 by William Ladd. We present the case of an adult patient with an occlusive condition caused by this anomaly, diagnosed promptly and safely resolved laparoscopically.