RARE CASE OF SMALL BOWEL OBSTRUCTION IN ADULTS- MIDGUT MALROTATION-LADD'S BAND

BACKGROUND Abnormalities of rotation and fixation of embryonic midgut commonly occur during neonatal period and in infancy(1). Incidence is about 1 in 6000 live births(2). Rarely it can be a cause of small bowel obstruction in adults. Ladd's bands are adhesions that connect right colon to right paracolic gutter which extends anterior to duodenum causing an external compression and obstruction of duodenum. CASE STUDY We had a young male patient of age 32 years who presented with symptoms suggestive of intestinal obstruction. He was evaluated, barium meal follow through series and CECT abdomen confirmed the diagnosis of midgut malrotation. Laparotomy was done and malrotation was corrected, Ladd's band released and mesenteric base widened and appendectomy was done. CONCLUSION This case is presented because of its extremely rare presentation in the young adult age group as a cause of small bowel obstruction and its difficulty in diagnosis and the risk of volvulus which is life threatening.