ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Surgical approach in a patient with intestinal malrotation associated with adult hypertrophic pyloric stenosis



Introduction. Intestinal malrotation and hypertrophic pyloric stenosis (HPS) are both rare diseases, usually diagnosed during infancy. In the medical literature there are only a few reports about infants who suffer from a combination of these diseases. The simultaneous occurrence of both diseases in adult patients is extremely rare. However, in this case, the surgical approach has to be a combination of different techniques, aiming at treating each one of the diseases separately.

Case presentation. A 37-years-old female patient who presented for upper gastrointestinal symptoms was diagnosed with adult hypertrophic pyloric stenosis (AHPS), intestinal malrotation and consequent dilated stomach. The diagnosis was based on the history,  clinical findings, imaging examinations (X-ray, abdominal computed tomography), and gastroscopy. The surgical approach included division of Ladd’s band and Jaboulay pyloroplasty.

Conclusions. The simultaneous occurrence of intestinal malrotation associated with AHPS is an extremely rare condition. Applying a combined surgical approach may have good postoperative results.

Keywords: intestinal malrotation, adult pyloric stenosis, dilated stomach, Ladd’s band, Jaboulay pyloroplasty.

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Address for correspondence:
Ventsislav DIMOV
Department of Anaesthesiology and Intensive Care, Military Medical Academy, Sofia, Bulgaria
Address: Sveti Georgi Sofiyski Str. 3, Sofia, Bulgaria
Email:; Phone: +359 88 777 3202


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Ivanov V, Dimov V, Lukanova T, Popadiin I, Vladov N. Surgical approach in a patient with intestinal malrotation associated with adult idiopathic hypertrophic pyloric stenosis. Arch Balk Med Union. 2020;55(3):483-488.