Case Report
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World J Gastrointest Surg. Jul 27, 2025; 17(7): 106700
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.106700
Congenital midgut reverse transposition with herniation of the jejunum into a malformed omentum: A case report
Qing Wang, Ke Sun, Xiao-Song Gong
Qing Wang, Ke Sun, Xiao-Song Gong, Department of General Surgery, Medical Center of Digestive Disease, Zhuzhou Central Hospital, Zhuzhou 412007, Hunan Province, China
Co-corresponding authors: Ke Sun and Xiao-Song Gong.
Author contributions: Wang Q performed the literature search and wrote the paper; Sun K and Gong XS reviewed the manuscript, submitted the paper, contributed equally to this article and are the co-corresponding authors of this manuscript; All authors read and approved the final version.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Song Gong, Bachelor, Associate Professor, Department of General Surgery, Medical Center of Digestive Disease, Zhuzhou Central Hospital, No. 116 Changjiang South Road, Zhuzhou 412007, Hunan Province, China. gxs20240831@163.com
Received: March 5, 2025
Revised: April 6, 2025
Accepted: May 19, 2025
Published online: July 27, 2025
Processing time: 140 Days and 23.2 Hours
Abstract
BACKGROUND

Congenital malrotation of the intestine is characterized by an abnormality in intestinal anatomy and mesenteric fixation resulting from disordered rotation of the intestine around the mesenteric artery during embryonic life. This disease can cause intestinal torsion, intestinal obstruction and other acute abdominal symptoms.

CASE SUMMARY

A 23-year-old female patient was admitted to our hospital on January 11, 2024, with a history of recurrent periumbilical pain for over 10 years and worsening for 6 months. In this report, the patient was diagnosed with a congenital midgut malrotation with herniation of the jejunum into a malformed omentum in surgery. The patient developed a hernia sac of the omentum adjacent to the duodenum, with the upper jejunum herniating to form an intra-abdominal hernia. During surgery, the jejunum-ileum and ileocecal junction were positioned according to their normal anatomy, and the mesentery root was linearly fixed to the posterior abdominal wall. Ascending colon and right transverse colon were repositioned in their normal anatomical locations. The patient was monitored for more than 1 year post-surgery and recovered well with no signs of abdominal pain or distension.

CONCLUSION

Congenital midgut reverse transposition is a specific malrotation of the intestine that is often found in adulthood. It is prone to forming intra-abdominal epiploic hernias. Personalized surgical treatment can achieve better results.

Keywords: Volvulus of midgut; Internal hernia; Omentum; Ileus; Abdominal pain; Case report

Core Tip: This paper describes the mechanism of congenital midgut reverse transposition, which is characterized by easy adult-onset and intraomental hernia. In this case, we performed personalized surgery according to the patient's intraoperative conditions. The operation achieved good results. The purpose of this case sharing is to provide a reference for clinicians to improve the diagnosis and treatment of similar cases. At the same time, we hope to actively explore laparoscopic surgery for intestinal volvulus and internal hernias in the future, because laparoscopic surgery can minimize surgical trauma and promote faster recovery of patients.