A Rare Case of Intestinal Malrotation in Pregnancy resulting in Hemicolectomy postnatally

Abstract

Small and large bowel obstruction secondary to volvulus on the background of intestinal malrotation is a very rare occurrence, especially in pregnancy. This can be associated with significant fetal and maternal morbidity and mortality. We report a case of a pregnant lady who developed symptoms of subacute intestinal obstruction during the second trimester of pregnancy and was subsequently diagnosed with intestinal malrotation. Although she had persistent symptoms of abdominal pain and constipation for nine long weeks during pregnancy, there was no evidence of intestinal obstruction or volvulus on her MRI abdomen. She underwent a caesarean section at 34 weeks due to worsening abdominal pain. Postnatally, she was diagnosed with midgut volvulus on CT scan, resulting in obstruction of both small and large bowel and required an emergency laparotomy and right hemicolectomy. The case highlights the importance of timely diagnosis and prompt management of intestinal obstruction with a multidisciplinary team approach.