A puzzling paradox: congenital bowel malrotation masquerading as duodenal atresia in a case of non-bilious emesis

• Main Authors: Jamani, Nurjasmine Aida, Mohd Lotfi, Amirah, Hassan, Radhiana
• Format: Article
• Language: English
• Published: Malaysian Medical Association 2024
• Subjects: R Medicine (General); RJ Pediatrics; RJ370 Disease of children
• Online Access: http://irep.iium.edu.my/117733/7/117733_congenital-bowel-malrotation.pdf; http://irep.iium.edu.my/117733/; https://mjmcasereports.org/articles/2024/v3n3/congenital-bowel-malrotation.pdf

Intestinal malrotation is a congenital abnormal bowel position within the peritoneal cavity, usually involving small and large bowels. It is considered primarily a disease of infancy with infrequent occurrence beyond the first year of life. The twisting and malposition of the intestine can cut off the blood supply. If undiagnosed for a prolonged duration, it can be fatal. Diagnosing malrotation of the gastrointestinal (GI) tract in newborn babies in primary care settings can be challenging, where it needs a structured approach with supportive clinical findings and examinations. Although it can be a straightforward diagnosis, approximately 15% of upper GI (UGI) studies result in equivocal findings, leading to false-positive and false-negative interpretations.1 We report a case of a five-day-old infant presenting with nonbilious vomiting with radiographic imaging of a double bubble sign, which was subsequently found to have bowel malrotation.