Intestinal malrotation associated with duodenal obstruction secondary to Ladd's bands

Two exploratory laparotomies within six days: A case of midgut volvulus in an adult with congenital malrotation

“…In our opinion, CT may be superior to ultrasound and upper gastrointestinal series in adults with acute symptoms. It depends on CT to find some special signs [ 4 , 16 , 20 ], such as corkscrew duodenum, abnormal position of duodenum and colon, inversion of the SMV and the SMA, and the whirlpool sign when volvulus occurred.…”

Gastric outlet obstruction: A red flag, potentially manageable

“…Other reported causes include Bouveret syndrome (an impacted gallstone in the proximal duodenum), phytobezoar, diaphragmatic hernia, gastric volvulus, and Ladd bands (peritoneal bands associated with intestinal malrotation). 7,28,29 ■ PRESENTING SYMPTOMS Symptoms of gastric outlet obstruction include nausea, nonbilious vomiting, epigastric pain, early satiety, abdominal distention, and weight loss.…”

Ladd's Band - A Case Report

“…Ladd's bands is a congenital anomaly of peritoneal embryogenesis and persist throughout life.Surgery is the treatment of choice as there is a high risk of vascular compromise and intestinal necrosis, so any patient with symptomatic malrotation should undergo emergency surgery.Ladd's procedures, first described in 1936, are performed by classical laparotomy for cases of intestinal malrotation. Currently this procedure can be performed by laparoscopy, a safe procedure and minimally invasive approach for adult patients without midgut volvulus(PANDA, et al 2014), associating the mobilization of the duodenum and right colon, sectioning Ladd's bands to near the superior mesenteric(SALA, et al 2016). Intestinal malrotation in adults is difficult to identify and the Ladd procedure by laparoscopy is the surgical technique of choice for these cases, when they do not present acute complications(ARAGÃO, et al 2018).…”