Delayed laparoscopic cholecystectomy in a case of acute cholecystitis and intestinal malrotation type I

  • Ana Arias | anaariasph2018@gmail.com Internal Medicine Service, Puerta de Hierro Hospital, Madrid, Spain.
  • Carlos Ordieres Internal Medicine Service, Alvarez Buylla Hospital, Mieres, Spain.
  • Adrian Huergo Internal Medicine Service, Alvarez Buylla Hospital, Mieres, Spain.
  • Marta Posadilla Internal Medicine Service, Alvarez Buylla Hospital, Mieres, Spain.
  • Pedro Amor Internal Medicine Service, Alvarez Buylla Hospital, Mieres, Spain.
  • Ana Milla Internal Medicine Service, Alvarez Buylla Hospital, Mieres, Spain.

Abstract

In adults, intestinal malrotation is an oligosymptomatic entity that is occasionally discovered during the course of diagnostic studies for other causes. In the case described herein, intestinal malrotation was discovered during investigation for cholelithiasis and acute cholecystitis. Malrotation may occur due to alterations in the asymmetric cellular dynamics of the mesentery responsible for intestinal shortening and unilateral retraction, this may occur as a secondary event following alterations in the expression of homeodomain transcription factors. The incidental finding of asymptomatic intestinal malrotation in adults does not preclude its surgical treatment. However, when intestinal malrotation is associated with cholecystitis, due to cholelithiasis, it is advisable, to first treat the cholecystitis conservatively, in our case, and then perform partial adhesiolysis of the Ladd bands that hinder access to the cystic area and carry out cholecystectomy by elective laparoscopy.

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Published
2019-02-20
Section
Case Reports
Keywords:
Intestinal malrotation, Cholecystititis, Cholelithiasis
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How to Cite
Arias, A., Ordieres, C., Huergo, A., Posadilla, M., Amor, P., & Milla, A. (2019). Delayed laparoscopic cholecystectomy in a case of acute cholecystitis and intestinal malrotation type I. Clinics and Practice, 9(1). https://doi.org/10.4081/cp.2019.1091