A RARE CAUSE OF SUB ACUTE INTESTINAL OBSTRUCTION IN ADOLESCENCE MALROTATION OF GUT WITH LADD'S BAND

Malrotation of the midgut is generally regarded as paediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adolescence and adults, which sometimes leads to delay in diagnosis and treatment. A high index of suspicion is therefore required when dealing with patients of any age group with abdominal symptoms. We present a case of a 17 year old boy who presented with an cyclic vomiting occassionally bile tinged,pre operative barium contrast study and operative findings confirming midgut rotation. The duodenum, small bowel, caecum and appendix were abnormally located, with the presence of classical Ladd's bands. The patient underwent an laparotomy with an uneventful postoperative recovery. A review of the literature is presented to highlight the rarity of intestinal malrotation and the controversies surrounding its management in the adolescent and adult population.