Visual Diagnosis in Emergency MedicineIntestinal Malrotation and Acute Left-Sided Appendicitis
Section snippets
Case Report
A 21-year-old man with syndactyly presented to this hospital with left-sided abdominal pain for 1 day. The patient described generalized periumbilical pain, which subsequently migrated to the left lower quadrant. The patient reported “eating a peanut butter and jelly sandwich,” but that he was “unable to finish it” due to increasing pain. The pain was exacerbated by “each bump while driving to the hospital,” and was associated with nausea, vomiting, anorexia, and chills.
Physical examination was
Discussion
Intestinal malrotation and left-sided appendicitis are rare but important diagnostic considerations for all Emergency Department Physicians. Intestinal malrotation, which is often associated with a myriad of other congenital abnormalities, occurs with anomalous midgut rotation around the superior mesenteric artery during weeks 5–12 of gestation (1). Intestinal malrotation is more common than frequently anticipated, as it is estimated to occur with an incidence of 1 out of every 500 births, with
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The radiologist says malrotation: does the surgeon operate?
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Cited by (4)
Association of anorectal malformation and intestinal malrotation
2015, American Journal of SurgeryCitation Excerpt :Surgical management of a child with malrotation involves the Ladd's procedure, which includes performing an appendectomy to remove the potential for delay in diagnosis in a malrotated child because of the abnormal anatomy with the appendix in the left abdomen. Although left-sided appendicitis is fairly rare, it is a documented occurrence in case reports in pediatric and adult literature.12,13 In a child with an anorectal malformation, performing an appendectomy as part of a Ladd's procedure must be weighed against the child's risk for poor bowel function in the future.
Left-sided appendicitis due to anatomical variation: A case report
2022, Frontiers in SurgeryLeft-Sided Acute Appendicitis: a Case Report and a Review of Literature
2019, Indian Journal of SurgeryClinical challenges and complications in the management of appendicitis
2014, Appendicitis: Risk Factors, Management Strategies and Clinical Implications