Late presentation of incomplete jejunoileal junction atresia with recurrent midgut volvulus; A case report for chronic midgut volvulus in adults

BACKGROUND: Despite the prevalence of intestinal malformation in Childs, late-onset during adulthood is rare and usually diagnosed incidentally. It may be present as subtle or vague abdominal pain following mid-gut volvulus. Computerized tomography may help diagnosis, but surgery remains the gold standard of diagnosis and treatment. CASE PRESENTATION: We presented a 24-year-old woman who complained of chronic intermittent abdominal pain, progressive food intolerance, and severe weight loss. Magnetic resonance enterography revealed dilated jejunum and collapsed ileum with slight bowel rotation around its mesentery (whirlpool sign), which was suggestive for mal-rotation of the intestine complicated by midgut volvulus, then the diagnosis was confirmed by laparotomy. During six months of follow-up after surgery, the patient's appetite improved significantly with eight kilograms of weight gain and resolution of abdominal pain. CONCLUSION: It may be a rationale to consider intestinal malformation as a differential diagnosis in a patient who complained of chronic abdominal pain with progressive weight loss, anorexia, and recurrent bowel obstructive symptoms.