Rotational anomalies are one of the most frequent of embryonic malformations related to the digestive tract. The incidence of malrotation is ∼1:500 births and the symptomatic incidence is 1:6000 [1, 2]. Intestinal malrotation refers to incomplete midgut rotation and fixation in early fetal life and can consist of complete absence of rotation, incomplete rotation—less than 270—or inverse rotation. In most cases Malrotation can present with other congenital anomalies and It is typically diagnosed during the first year. We report a rare case of malrotation with LADD band presenting in an 11 year old girl accompanying intrinsic duodenal stenosis and annual stenosis. Case report : A 11-year-old-girl presented to the hospital with the chief complaints of abdominal pain, epigastric fullness, bilious vomiting, …show more content…
This findings are concerning enough to prompt the surgeon to consider operative exploration[6]. After stabilizing the fluid and electrolyte imbalance, the surgery was taken. Exploratory laparotomy showed extended stomach and first two parts of the duodenum, free cecum in the upper part of the abdomen, malrotation with Ladd's band extending from the colon to the liver pressing the second part of the duodenum. The bands were cut freeing the duodenum. Interior duodenal stenosis also was found so Duodenoduodenostomy (diamond) was performed with Ladd's procedure after Gastro-jejunostomy (Omega) was made. From 30 to 60% of patients with malrotation or malfixation can have other associated congenital anomalies, either inside or outside the abdominal cavity[7]. In our case the patient was also diagnosed with duodenal stenosis and anal stenosis . Anal stenosis caused her constipation early in life and was fixed with