A case of rectosigmoid cancer with reverse intestinal malrotation

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Reverse intestinal malrotation accounts for only approximately 4% of cases of intestinal malrotation, which has a prevalence of 1 in 10,000 individuals. A case of rectosigmoid cancer presenting with reverse intestinal malrotation is presented, with reference to the literature. The patient was a 56-year-old woman in whom reverse intestinal malrotation was suspected on barium enema and CT performed as preoperative tests for rectosigmoid cancer. On laparotomy, the descending colon was weakly fixed onto the right-side wall, and the ascending colon was located directly to its left. The entire small intestine was deviated to the left side of the abdomen, and Ladd's bands were not observed. As suspected on preoperative imaging, the patient was diagnosed with reverse intestinal malrotation. A low anterior resection of the rectum with sufficient D3 lymph node dissection was safely performed by preoperatively determining that the patient had intestinal malrotation complicated by deformity. The pathological diagnosis was SS, pN2(12/55)H0P0M0 fStage IIIb. Aggressive treatment with enhanced recovery after surgery (ERAS) was given during the perioperative period, and the patient was surgically ready to be discharged by postoperative day 7.
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