Má rotação intestinal na adolescência e suas consequências no diagnóstico tardio: relato de caso

Gislei Frota Aragão; Ronaldo Sobreira Guedes Filho; João Henrique Freitas Colares; Jamille Linhares Feijó; Manuel Luiz Filgueira Oliveira; Yasmin Ingrid Santos Oliveira

doi:10.23925/1984-4840.2018v20i3a12

Authors

Gislei Frota Aragão Universidade Estadual do Ceará – Fortaleza (CE), Brasil. http://orcid.org/0000-0002-0689-8371
Ronaldo Sobreira Guedes Filho Universidade Estadual do Ceará – Fortaleza (CE), Brasil. http://orcid.org/0000-0002-4934-3800
João Henrique Freitas Colares Hospital Infantil Albert Sabin – Fortaleza (CE), Brasil. http://orcid.org/0000-0002-9138-2053
Jamille Linhares Feijó Hospital Infantil Albert Sabin – Fortaleza (CE), Brasil. http://orcid.org/0000-0002-9809-832X
Manuel Luiz Filgueira Oliveira Escola de Saúde Pública do Ceará – Fortaleza (CE), Brasil. http://orcid.org/0000-0003-2544-8445
Yasmin Ingrid Santos Oliveira Universidade Estadual do Ceará – Fortaleza (CE), Brasil. http://orcid.org/0000-0003-3204-5943

DOI:

https://doi.org/10.23925/1984-4840.2018v20i3a12

Keywords:

congenital abnormalities, digestive system abnormalities, intestines, delayed diagnosis, adolescent, laparoscopy

Abstract

Intestinal malrotation is a congenital anomaly of unknown cause, being bilious vomiting one of the differential diagnoses in childhood, although its diagnosis in adults is difficult. A 17-year-old adolescent started with mesogastric pain, of intermittent character, with postprandialworsening. He presented severe abdominal pains, bilious vomiting, dehydration and severe malnutrition. He underwent endoscopy and upper digestive seriography, which suggested intestinal malrotation. The patient underwent the Ladd procedure by video laparoscopy. During the surgery, the cecum was found in the left upper quadrant, stomach and first duodenal portion dilated by presence of Ladd band in the second duodenal portion. Lysis of the bands of Ladd, appendectomy and repositioning of the handles were performed in the patient. He was discharged after four days. It is difficult to identify intestinal malrotation in adults, and the Ladd laparoscopic procedure is the surgical technique of choice for these patients without acute complications.

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