Nonrotation of the Prearterial Segment of Midgut Presenting as Duodenal Obstruction in a 60-Year-Old Man

Ha Na Park; Jae Jun Park; Jae Hee Cheon; Woo Jin Hyung; Sang Ho Cho; Ki Hwang Kim; Tae Il Kim; Won Ho Kim

doi:10.4166/kjg.2010.55.4.252

Journal List > Korean J Gastroenterol > v.55(4) > 1006654

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Park, Park, Cheon, Hyung, Cho, Kim, Kim, and Kim: Nonrotation of the Prearterial Segment of Midgut Presenting as Duodenal Obstruction in a 60-Year-Old Man

Original Article

Korean J Gastroenterol 2010;55(4):252-255.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.55.4.252

Nonrotation of the Prearterial Segment of Midgut Presenting as Duodenal Obstruction in a 60-Year-Old Man

Ha Na Park, M.D.^∗, Jae Jun Park, M.D.^∗,^†, Jae Hee Cheon, M.D.^∗,^†,, Woo Jin Hyung, M.D.^†,^‡, Sang Ho Cho, M.D.^§, Ki Hwang Kim, M.D.^†,^∥, Tae Il Kim, M.D.^∗,^†, Won Ho Kim, M.D.^∗,^†

^∗Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

^†Department of Division of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

^‡Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

^§Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

^∥Department of Radiology, Yonsei University College of Medicine, Seoul, Korea

Correspondence to: Jae Hee Cheon, M.D. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 134, Shinchon- dong, Seodaemun-gu, Seoul 120-752, Korea Tel: +82-2-2228-1990, Fax: +82-2-393-6884 E-mail: geniushee@yuhs.ac

Received 11 October 2009 Accepted 4 November 2009

Abstract

Intestinal malrotation is a developmental anomaly resulting from embryologic failure of fixation and rotation of the gut and predisposed to midgut vovulus and small bowel obstruction. Although various forms of malrotation anomalies in the gut can occur, nonrotation of prearterial segment with the initial symptomatic presentation at advanced age has been rarely reported. Here, we report a case of nonrotation of the prearterial segment of the midgut presenting with duodenal obstruction in a 60-year-old man. To our best knowledge, this is the first case reported about nonrotation of prearterial segment of the midgut in Korea.

Keywords: Intestinal malrotation, Nonrotation, Duodenal obstruction, Midgut

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Fig. 1.

(A, B) Esophagogastro-duodenoscopic examination showed discrete red streaky superficial erosions longer than 5 mm, at esoph-agogastric junction just above Z- line and large amount of bile sta-sis in the stomach.

Fig. 2.

Computed-tomography showed markedly distended duode-num, proximal jejunum and abnormally located superior mesenteric vein (arrow).

Fig. 3.

Upper gastrointestinal series showed abnormal right-sided uodenojejunal flexure and segments of luminal narrowing of je-num owing to an extrinsic process.

Fig. 4.

Microscopic appearance of the adhesion band revealed fi-bromuscular tissue (H&E stain, ×100).

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