Background :Intestinal malrotation is a rare congenital abnormality occurring in 0.2–1% of the population.Cases diagnosed in adulthood are even rarer, thus constituting a diagnostic challenge. Case presentation : we report a case of 43 year-old patient presenting with an exceptional combination of left paraduodenal hernia and complete common mesentery whose management was performed laparoscopically. Conclusion :This case documented a rare anatomic variant, combining two abnormalities of intestinal rotation diagnosed in adulthood.