Nonrotation of the intestine: embryological and clinical correlation

Velavan SS, Castellanos B, Gul

Abstract

A defect in the rotation of midgut to assemble the parts of the gut in the normal anatomical location results in nonrotation. This is a very rare variation with an incidence of 1:500. This case is reported for its extreme rarity and its resultant clinical implications. During routine dissection, the entire small intestine was found to lie on the right side of the abdominal cavity. The duodenum was located to the right of superior mesenteric artery. The ileocecal junction was traced to the hypogastrium. The colon formed a loop on the left half, and sigmoid colon was typically located. A fibrous Ladd’s band extended from posterior abdominal wall to the colon, crossing anterior to the duodenum. The clinical presentation of nonrotation ranges from vague intermittent pain to acute bowel obstruction. Adequate knowledge of Embryology and resultant variations aid in understanding the abnormal findings during diagnostic interventions and prevents surgical complications.