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BACKGROUND Reverse rotation of the midgut is a rare type of intestinal malrotation. Volvulus of the right colon or entire midgut, stenosis of the transverse colon and obstruction of the duodenojejunal junction are common complications of reverse rotation. In this study, we report the first case of intestinal obstruction associated with reverse rotation in pregnancy. CASE SUMMARY A 31-year-old woman at 36 +2 wk gestation presented to the emergency department with progressive abdominal cramping, nausea and bilious vomiting. Abdominal ultrasound scanning showed dilatation of the bowel. Computed tomography scanning revealed features of reverse rotation of the midgut with intestinal volvulus. After consultation with the obstetrician, the pregnancy was terminated and exploratory abdominal surgery was performed. Intra-operatively, it was found that the mesentery of the colon and small intestine was insufficiently attached. The right colon and the small intestinal mesentery was twisted, and intestinal necrosis was observed. The duodenum and duodenojejunal junction were curved in front of the transverse colon, and the transverse colon passed through the tunnel behind the mesenteric root. Intestinal reverse rotation with volvulus was confirmed. The ‌necrotic intestine was resected and small intestine mesenteric reconstruction was performed. The patient recovered after surgery. After leaving the hospital, the patient and her daughter remained well during an 8-month follow-up period. CONCLUSION We report the diagnosis, treatment and etiology of a pregnant patient with intestinal obstruction due to reverse rotation of the midgut. For similar cases, appropriate diagnosis and treatment should be carried out according to the condition of the fetus and pregnant woman.

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Background Situs inversus totalis (SIT) is a rare genetic congenital disease, characterized with complete right-to-left inversion of all the internal organs. We herein describe a meaningful case which was diagnosed as gallbladder adenosquamous carcinoma, a rare histology type of gallbladder cancer, with SIT. Case Presentation A 59-year-old Chinese woman was admitted for persistent epigastric distention and intermittent abdominal pain. The abdominal CT scan revealed a huge mass at the gallbladder bottom, involving the adjacent transverse colon and liver. En-bloc radical resection of the gallbladder cancer, including partial colectomy and hepatectomy with regional node dissection, followed by colocolostomy and Roux-en-Y choledochojejunostomy, was successfully performed. Pathology analysis indicated an adenosquamous carcinoma with positive adenocarcinoma markers (CK7, CK19) and squamous carcinoma markers (CK5/6, P63). Conclusion The SIT anomaly might increase the risk of malignancies by sharing genome mutations, suggesting the importance of surveillance in the SIT settings.