Single-port transumbilical laparoscopic appendectomy combined with Ladd procedure in intestinal malrotation: A case report.

Introduction: Acute appendicitis associated with intestinal malrotation is uncommon and may pose diagnostic and technical challenges. We report the first described case of appendectomy associated with Ladd procedure performed through a single-port transumbilical laparoscopic approach.

Clinical case: A 9-year-old girl presented with acute abdominal symptoms on a background of chronic recurrent abdominal pain. Imaging revealed acute appendicitis in an atypical supravesical position and inversion of mesenteric vessels consistent with intestinal malrotation without volvulus. A single-port transumbilical laparoscopic approach was used, allowing simultaneous appendectomy and Ladd procedure through the same umbilical access. The postoperative course was uneventful, and the patient was discharged on postoperative day one. At one year of follow-up, she remains asymptomatic with an excellent cosmetic result.

Conclusion: Single-port transumbilical laparoscopy enabled safe and effective combined management of appendicitis and intestinal malrotation and may represent a minimally invasive alternative in selected pediatric patients.