Introduction:

intestinal malrotation is a congenital disorder associated with a lack of rotation of the midgut, often related to other congenital anomalies. It affects 1% of the population and is diagnosed in 90% of the cases before the age of one year. In adults the diagnosis is difficult, the symptoms are vague and unspecific, in many occasions the high intestinal occlusion is the only manifestation.

Clinical case:

50-year-old male, with a history of early satiety, presents with abdominal distention with peritoneal irritation, abdominal radiography in standing and decubitus with hydroaereal levels, image in pile of coins, interasa edema and intestinal dilatation, proceed to exploratory laparotomy, finding, intestinal malrotation type IIIB, Ladd procedure is performed, observing; ascending colon and ileum in spiral, with impossibility for adequate fixation, with high risk of torsion and subsequent necrosis, it is decided right hemicolectomy with ileotransverse laterolateral anastomosis.

Conclusions:

Ladd’s procedure is the surgical management of choice, however; in the presence of associated congenital alterations, each case will have to be individualized in order to minimize the risk of complications.