Reverse Rotation Anomaly Complicated By Internal Herniation, Small Bowel Volvulus, and Dual Gastrojejunostomal Fistulas In A Child: A Rare Pediatric Case Report
Özet
Reverse rotation anomaly is a rare congenital malformation of the midgut in which the transverse colon passes posterior to the superior mesenteric artery (SMA), predisposing patients to intestinal obstruction, internal hernia, and volvulus. Gastrointestinal fistula formation associated with this anomaly is exceptionally uncommon. We present a rare pediatric case of reverse rotation anomaly complicated by mesocolic internal herniation, small bowel volvulus, and dual gastrojejunostomal fistulas. A 10-year-old girl presented with severe colicky abdominal pain, bilious vomiting, weight loss, and oral intolerance. Computed tomography (CT) demonstrated abnormal retroarterial positioning of the transverse colon and findings suspicious for volvulus. Following preoperative stabilization and correction of anemia, surgical exploration revealed transverse colon entrapment, mesocolic defects, small bowel volvulus, and two gastrojejunostomal fistulas. Surgical repair was successfully performed. This case highlights the importance of considering rare rotational anomalies in children presenting with chronic obstructive gastrointestinal symptoms.
Referanslar
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