DOI: 10.36347/sjmcr.2015.v03i06.023

Pages: 523-525

We report a case of sigmoid volvulus and recurrent acute appendicitis mimicking peptic ulcer disease in a previously undiagnosed malrotation of the gut in an adult. Our patient is a 34 year old woman, with recurrent left upper abdominal pain and acute on chronic intestinal obstruction secondary to sigmoid volvulus with malrotation of the gut, whose previous upper abdominal pain was misdiagnosed as recurrent peptic ulcer disease. Intraoperatively the patient appendix and sigmoid colon were found at the left upper abdomen and the right lower abdomen respectively resulting in atypical presentation of acute appendicitis. This case emphasize the importance of upper gastrointestinal endoscopic study prior to treatment of peptic ulcer disease and high index of suspicion / consideration of malrotation of the gut in adult patients with persistent abdominal pain often diagnosed as non specific abdominal pain. The diagnosis of malrotation of the gut is rarely considered in adult and often leads to delay and incorrect diagnosis of ordinarily common conditions. Thus a high index of suspicion is required when evaluating adult patients with non specific abdominal pain or lack of response to instituted treatment.