Unusual Co-Existence of Colon Carcinoma & Malrotation of Gut in Elderly Female: A Rare Case Report and Literature Review

Abstract

Introduction: Intestinal malrotation (IM) usually presents as intestinal obstruction or midgut volvulus in childhood but rarely presents in adults either asymptomatically or with abdominal symptoms. Colorectal cancer in adult patients with malrotation is even more rare. Place: Department of General Surgery. All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, 229405, India. Case Presentation and Discussion: We report a case of gut malrotation with colon cancer causing sub-acute intestinal obstruction (SAIO), who underwent open laparotomy. A 60-year-old woman on treatment for suspected bowel TB came with waxing and waning course of intestinal obstruction. Outside colonoscopy/imaging were inconclusive. Institutional computer tomography (CT) scan suggested gut malrotation. Patient underwent an emergency laparotomy with an uneventful postoperative recovery. An intraluminal growth was found in ascending colon along with malrotated bowel. We felt content in heading the distressed patient towards correct therapeutic course. Conclusion: This is 3rd such case documented from India out of 82 cases globally. This report raises awareness about colorectal malignancies in symptomatic adults with IM, though the cause remains uncertain.