Ulus Travma Acil Cerrahi Derg. 2018; 24(2): 178-180 | DOI: 10.5505/tjtes.2017.58726

Intestinal nonrotation and left-sided perforated appendicitis

Ertan Zengin¹, Arzu Turan¹, Ahmet Salih Çapaloglu², Ercan Nalbant², Gürkan Altuntaþ^2
1Department of Radiology, Recep Tayyip Erdoðan University Faculty of Medicine, Rize-Turkey
²Department of Emergency Medicine, Recep Tayyip Erdoðan University Faculty of Medicine, Rize-Turkey
³Department of Pediatric Surgery, Recep Tayyip Erdoðan University Faculty of Medicine, Rize-Turkey

Acute appendicitis is the most common cause of acute abdominal pain, requiring emergency surgery. Approximately one third of cases have pain unexcepted location due to its various anatomical location. Acute appendicitis is a very rare cause of left lower quadrant pain; if it occurs, a few congenital anomalies should be considered such as Situs Inversus totalis and Midgut Malrotation (MM). MM is a rare congenital anomaly; it occurs due to error in process of rotation or fixation of intestines around the superior mesenteric vessels and it refers to nonrotation or incomplete rotation of intestines. Here we report a case who presented with left lower abdominal pain and was diagnosed with acute perforated appendicitis with intestinal nonrotation. Clinicians should be aware that intestinal nonrotation may be presented with left lower quadrant pain and complicated by acute appendicitis.

Keywords: Acute appendicitis, intestinal nonrotation; left lower abdominal pain; midgut malrotation.

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Ýntestinal nonrotasyon ve sol alt kadranda perfore apandisit

Ertan Zengin¹, Arzu Turan¹, Ahmet Salih Çapaloglu², Ercan Nalbant², Gürkan Altuntaþ^2
1Recep Tayyip Erdoðan Üniversitesi Týp Fakültesi, Radyoloji Anabilim Dalý, Rize
²Recep Tayyip Erdoðan Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Rize
³Recep Tayyip Erdoðan Üniversitesi Týp Fakültesi, Çocuk Cerrahisi Anabilim Dalý, Rize

Akut apandisit, acil cerrahi gerektiren en yaygýn akut karýn aðrýsý nedenlerinden biridir. Apendiksin varyasyonel anatomik lokalizasyonlarýndan dolayý olgularýn yaklaþýk üçte birinde farklý bir kadranda aðrý olabilir. Akut apandisit, sitüs inversus totalis (SIT), Midgut malrotasyon (MM) gibi birkaç doðuþtan anomali dýþýnda sol alt kadran aðrýsýnda nadiren akla gelir. Midgut malrotasyon nadir bir doðuþtan anomali olup superior mezenterik damarlarýn etrafýnda rotasyon veya baðýrsaklarýn fiksasyonu hatasýndan kaynaklanýr ve baðýrsaðýn inkomplet rotasyonu veya nonrotasyonu anlamýna gelir. Burada sol alt kadran aðrýsý ile baþvuran ve akut perfore apandisit tanýsý alan intestinal nonrotasyonlu bir olgu sunuldu. Klinisyenler intestinal nonrotasyonun sol alt kadran aðrýsý ile prezente olan akut apandisit ile komplike olabileceðini bilmeli, sol alt kadran lokalizasyonlu apandisitlerde intestinal nonrotasyon akla gelmelidir.

Anahtar Kelimeler: Akut apandisit, intestinal nonrotasyon; Midgut malotasyon; sol alt karýn aðrýsý.

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