https://doi.org/10.4081/ecj.2025.13647
Non-operative treatment for bowel obstruction in a 37-year-old woman with common mesentery: a case report
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Published: 4 July 2025
Common mesentery is a rare congenital anomaly caused by abnormal rotation of the omphalomesenteric loop during embryonic development. We report the case of a 37-year-old woman who presented with lower abdominal pain and fever. Physical examination revealed localized tenderness, and laboratory tests showed elevated inflammatory markers. Computed tomography revealed common mesentery with small bowel obstruction, and abnormal cecal positioning. There were no signs of ischemia or perforation. Conservative treatment was initiated, including nasogastric decompression, Gastrografin challenge, intravenous fluids, analgesics, and antiemetics. The patient improved clinically, tolerated refeeding, and was discharged on day five. At three-month follow-up, she remained asymptomatic. Magnetic resonance imaging confirmed the congenital anomaly and excluded other pathological findings. This case demonstrates that non-operative management may be an effective option in stable adult patients with bowel obstruction due to common mesentery.
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Jabra SB, Chaouch MA, Moussa A, et al. Incomplete common mesentery with Ladd’s band and Meckel’s diverticulum: A rare cause of small bowel obstruction. Int J Surg Case Rep 2023;106:108159. DOI: https://doi.org/10.1016/j.ijscr.2023.108159
Oudou AZ, Soumana ID, Souiki T, et al. Volvulus total du grêle sur mésentère commun incomplet, une complication exceptionnelle chez l’adulte: à propos d’un cas. Pan Afr Med J 2019 J;33:220).
Aissaoui R, Nasri S, Mahjouba H, et al. Complete common mesentery revealed by acute perforated appendicitis: case report and review of the literature. Radiol Case Rep 2022;18:441–3. DOI: https://doi.org/10.1016/j.radcr.2022.10.069
Matzke GM, Dozois EJ, Larson DW, Moir CR. Surgical management of intestinal malrotation in adults: comparative results for open and laparoscopic Ladd procedures. Surg Endosc 2005;19:1416–9. DOI: https://doi.org/10.1007/s00464-004-8249-7
Behi H, Ayadi TY, Omry A, et al. Total small bowel volvulus on incomplete common mesentery, an exceptional complication in geriatric patients: A rare case report. Int J Surg Case Rep 2024;118:109585. DOI: https://doi.org/10.1016/j.ijscr.2024.109585
Oudou AZ, Soumana ID, Souiki T, et al. [Total small bowel volvulus complicating common incomplete mesentery, an exceptional complication in adults: about a case]. Pan Afr Med J 2019;33:220. DOI: https://doi.org/10.11604/pamj.2019.33.220.18159
Kapfer SA, Rappold JF. Intestinal malrotation-not just the pediatric surgeon’s problem. J Am Coll Surg 2004;199:628–35. DOI: https://doi.org/10.1016/j.jamcollsurg.2004.04.024
Khalid J. A Complete common mesentery presenting with appendicular peritonitis: case report: case report. Am J Med Clin Res Rev 2024;3:1–4. DOI: https://doi.org/10.58372/2835-6276.1141
Low SF, Ngiu CS, Sridharan R, Lee YL. Midgut malrotation with congenital peritoneal band: a rare cause of small bowel obstruction in adulthood. Case Rep 2014;2014:bcr2013202690. DOI: https://doi.org/10.1136/bcr-2013-202690
Mizuta N, Kikuchi T, Fukuda Y. Adult intestinal malrotation treated with laparoscopic ladd procedure. Case Rep Surg 2022;2022:6874885. DOI: https://doi.org/10.1155/2022/6874885
Jansen JO, Driver CP, Duncan JL. Unusual hindgut malrotation and associated mesenteric vascular abnormality presenting as large bowel obstruction in an adult. Surgeon 2007;5:109–10; quiz 110, 121. DOI: https://doi.org/10.1016/S1479-666X(07)80064-3
Parag P, Chacko J, Thomas G. Colonic obstruction in classical malrotation. Indian Pediatr 2000;37:440–1.
Khalifa MB, Missaoui W, Elguedr W, et al. Complete common mesentery revealed by a cecal bascule: Two case reports. Int J Surg Case Rep 2025;129:111160. DOI: https://doi.org/10.1016/j.ijscr.2025.111160
Butterworth WA, Butterworth JW. An adult presentation of midgut volvulus secondary to intestinal malrotation: A case report and literature review. Int J Surg Case Rep 2018;50:46–9. DOI: https://doi.org/10.1016/j.ijscr.2018.07.007
Grassi C, Conti L, Palmieri G, et al. Ladd’s band in the adult, an unusual case of occlusion: Case report and review of the literature. Int J Surg Case Rep 2020;71:45–9. DOI: https://doi.org/10.1016/j.ijscr.2020.04.046
Powell DM, Othersen HB, Smith CD. Malrotation of the intestines in children: The effect of age on presentation and therapy. J Ped Surg 1989;24:777–80. DOI: https://doi.org/10.1016/S0022-3468(89)80535-4
Moldrem AW, Papaconstantinou H, Broker H, et al. Late presentation of intestinal malrotation: an argument for elective repair. World J Surg 2008;32:1450. DOI: https://doi.org/10.1007/s00268-008-9490-3
Cheikhelard A, Lagausie PD, Garel C, et al. Situs inversus and bowel malrotation: Contribution of prenatal diagnosis and laparoscopy. J Ped Surg 2000;35:1217–9. DOI: https://doi.org/10.1053/jpsu.2000.8730
Raphaeli T, Parimi C, Mattix K, Javid PJ. Acute colonic obstruction from Ladd bands: a unique complication from intestinal malrotation. J Ped Surg 2010;45:630–1. DOI: https://doi.org/10.1016/j.jpedsurg.2009.12.026
Cohen Z, Kleiner O, Finaly R, et al. How much of a misnomer is “asymptomatic” intestinal malrotation? Isr Med Assoc J 2003;5:172–4.
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