Concurrent Gastro Gastric Invagination and Intestinal Malrotation in Adult: A Case Report

Abstract

Introduction: Intestinal malrotation and invagination are two rare disorders that typically affect children and can present with vague symptoms. Intestinal malrotation occurs when the intestine fails to rotate and fixate normally, while invagination is when one intestinal organ enters another. In adults, intestinal malrotation is very rare, accounting for only 0.2 - 0.5% of cases. Gastric invagination, on the other hand, occurs in 10% of cases and can be challenging to diagnose, even with adequate examinations. Recently, a case was reported of a close loop duodenum resulting from gastric obstruction caused by gastrogastric invagination and concomitant intestinal malrotation. Case Report: A 40-year-old woman came to the emergency room with severe vomiting for 1 day. History of chronic right upper abdominal and epigastric pain for the last 1 year. Founding gastric obstruction through endoscopy and considered to perform exploratory laparotomy. There was a gastro gastric invagination with a leading point gastrointestinal stromal tumour in the major curvature of the gastric corpus and intestinal malrotation. Wedge resection of the tumour and untwist of the malrotation were performed. Conclusion: The diagnosis of gastric invagination and small bowel malrotation in adults is difficult and challenging due to clinical symptoms that mimic other intestinal disorders. Increasing awareness of these cases will certainly reduce the time to diagnosis, expedite action and improve patient outcomes.