TY - JOUR AU - Avgoustou, Constantinos AU - Avgoustou, Christina PY - 2021/06/15 Y2 - 2024/03/29 TI - Obscure duodenal malformation and other midgut malrotation defects in an elder with acute abdomen due to different prominent complicated pathology JF - Journal of Gastric Surgery JA - J Gastric Surg VL - 3 IS - 2 SE - Case Report DO - 10.36159/jgs.v3i2.83 UR - https://www.journalofgastricsurgery.com/index.php/JGS/article/view/83 SP - AB - <p>A 70-year old&nbsp; man with severe comorbidities, hemodynamically stable, was emergently admitted for bowel obstruction. His chronic intractable constipation had never been &nbsp;evaluated.&nbsp; The patient had&nbsp; no history of abdominal&nbsp; surgery.&nbsp; Computed tomography indicated a large obstructive rectosigmoid tumour&nbsp; and dolichocolon.&nbsp;&nbsp; Immediate rectoscopy confirmed the presence of the obstructive tumour. Additionally, on emergent laparotomy, a malformed&nbsp; right-sided &nbsp;duodenum with right-sided small bowel and other midgut malrotation defects, along with a small palpable lesion in the proximal descending colon, were also found. We performed a subtotal &nbsp;colectomy, mobilization of the only existing first and second duodenal portions,&nbsp; division of mesenteric root adhesions, and &nbsp;a terminal ileostomy. The patient had a favourable outcome, was discharged on day 8. Histology revealed a pT3N1b rectosigmoid adenocarcinoma and an 1 cm in diameter localized &nbsp;c-kit+ stromal tumour in the proximal descending colon.&nbsp; He received chemotherapy. The patient underwent a postoperative upper gastrointestinal contrast study which showed a well-functioning right-sided deranged duodenum. During a 36-months follow-up no recurrence of malignancy or of midgut malrotation defects has been recognized.</p> ER -