Intestinal obstruction from midgut volvulus after laparoscopic cholecystectomy. A report of an unusual complication

Congenital midgut malrotation, a rare anatomic anomaly that can lead to duodenal or small bowel obstruction, rarely is recognized beyond the first year of life. We report a case of unrecognized congenital midgut malrotation that resulted in midgut volvulus, causing intestinal obstruction and requiring emergent reoperation after laparoscopic cholecystectomy. This unusual complication, first reported in 1994, involved a 56-year-old man and resulted in cecal infarction recognized and treated on the second postoperative day. This second case describes a less acute postoperative course, with multiple bouts of partial bowel obstruction leading to two readmissions and finally resulting in a reexploration and definitive treatment on the 19th postoperative day.

Intussusception in an adult secondary to an inverted Meckel's diverticulum

Intussusception secondary to an inverted Meckel's diverticulum is considered to be a rare occurrence. The pathophysiology of the disease process results in a complicated clinical picture of chronic abdominal pain, lower gastrointestinal bleeding, and recurrent obstructive symptoms that may lead to an unnecessary delay in diagnosis. A case of an inverted Meckel's diverticulum as a lead point for an ileocolic intussusception in an adult is presented. The methods of diagnosis and the salient concepts in the surgical management of intussusception are discussed. Special features regarding the pathophysiology and treatment of an inverted Meckel's diverticulum acting as an intussusception are also reviewed.