Intestinal Malrotation as a Cause of Chronic Recurring Abdominal Pain in Adult with Caudal Regression Syndrome

Abstract

During embryological development, the midgut undergoes a process of growth and lengthening, which begins at week 5 of gestation and ends shortly after birth and also includes herniation in the umbilical cord, rotation, reduction and fixation. Rotation occurs counterclockwise around the superior mesenteric artery and ends at week 12, at which time the intestine re-enters the abdominal cavity and is attached to the parietal peritoneum, with different anchor points. If the rotation is not correct, a good fixation is not possible. The second, third, and fourth portions of the duodenum, the ascending and descending colon, attach to the retroperitoneum. The duodenojejunal junction is fixed by the ligament of Treitz and the small intestine by a wide meso that extends from that ligament to the ileocecal valve [1-3].