Unusual presentation of left sided acute appendicitis in elderly male with asymptomatic midgut malrotation.

Abstract

INTRODUCTION:

Acute appendicitis in the setting of midgut malrotation is uncommon. Midgut malrotation commonly presents within the first month of life. A minority remain asymptomatic and may present with concomitant abdominal pathology making diagnosis difficult.

PRESENTATION OF CASE:

This paper reports a rare case of a 73-year-old male diagnosed with acute appendicitis and asymptomatic MM .The patient underwent a laparoscopic appendectomy, but had an unplanned return to theatre for washout of post-operative intra-abdominal haematoma.

DISCUSSION:

Midgut malrotation is commonly described by the stringer classification and type 1a is the most common in adults. There have only been a handful of documented cases of acute appendicitis with midgut malrotation occurring in the adult population. Previous delay in diagnosis has led to a delay in definitive management. Both laparoscopic and open surgery has been used in the past.

CONCLUSION:

Acute appendicitis with malrotation should be considered in elderly patients presenting with atypical signs and symptoms. Imaging offers significant advantage for timely and definitive management.

• Authors: Animesh A Singla, Joshua Rajaratnam, Apresh A Singla, Stephanie Wiltshire, Charlotte Kwik, Michelle Smigelski, Mathew J Morgan
• Journal: International journal of surgery case reports (Int J Surg Case Rep) Vol. 17 Pg. 42-4 ( 2015) ISSN: 2210-2612 [Print] Netherlands
• PMID: 26520036 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.