Discussion of a case report describing: total gastrectomy in an adult with intestinal malrotation

Herein, we will review a case report published by Tonouchi et al. which highlights the unique challenges of performing a total gastrectomy in a patient found to have intestinal malrotation (1). Intestinal malrotation in adults is a relatively rare pathology with a reported incidence of less than 1% (2). Intestinal malrotation occurs due to failure of the midgut to appropriately rotate 270 degrees counter-clockwise around the superior mesentery artery (SMA). This deficit in rotation results in a narrowed attachment of the midgut mesentery and places the midgut at risk for volvulus.