MANAGEMENT OF ANOMALOUS ROTATION IN ADULTS

Rotational anomalies of the gut are infrequently encountered in the ad ult population. Management of this population is debatable because of a few anecdotal reports and small patient series. We present the succe ssful surgical correction of a patient with symptomatic nonrotation an d review our experience with six asymptomatic patients with anomalous rotation discovered incidentally at laparotomy for another disease pro cess. The incidence of anomalous rotation is reported as high as 0.5% in autopsy series. Therefore, a large majority of subjects are clinica lly silent throughout life. Although a surgical emergency in the pedia tric population, serendipituous discovery in the asymptomatic adult do es not require surgical intervention. It is important, however, that t he patient have a thorough understanding of his abnormality so that sh ould symptoms arise, urgent surgical intervention may be warranted. We recommend appendectomy in those patients undergoing laparotomy for ot her conditions. In patients with chronic abdominal symptoms, surgical intervention is warranted.