Reverse Rotation Anomaly Complicated By Internal Herniation, Small Bowel Volvulus, And Dual Gastrojejunostomal Fistulas In A Child: A Rare Pediatric Case Report
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.
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Olgular Eşliğinde Çocuk Cerrahisi
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