{"id":20277,"date":"2026-07-31T10:32:40","date_gmt":"2026-07-31T10:32:40","guid":{"rendered":"https:\/\/woncaeurope2026.org\/sessions\/an-interesting-case-of-subacute-malrotation-of-midgut-presented-in-middle-age\/"},"modified":"2026-07-31T10:32:40","modified_gmt":"2026-07-31T10:32:40","slug":"an-interesting-case-of-subacute-malrotation-of-midgut-presented-in-middle-age","status":"publish","type":"wsa_session","link":"https:\/\/woncaeurope2026.org\/fr\/sessions\/an-interesting-case-of-subacute-malrotation-of-midgut-presented-in-middle-age\/","title":{"rendered":"An interesting case of subacute malrotation of midgut presented in middle age."},"content":{"rendered":"<p>A 54-year-old gentleman presented to the surgery\u00a0 with intermittent abdominal pain, changes in bowel habits and lower urinary tract symptoms recurring over the last few years. All necessary investigations were performed but the diagnosis was unclear. Later in the course he presented with abdominal pain and change in bowel habits. Because of his age and change in bowel habits, investigations were arranged including blood tests, stool for microscopy and culture, faecal calprotectin and a faecal immunochemical test (FIT) to rule out lower bowel pathology (i.e. inflammatory bowel disease or bowel cancer). Blood tests and stool culture were normal. The faecal calprotectin was high (310 micrograms\/g) and positive FIT (106.9 micrograms\/g). He was referred on suspected cancer care pathway and was reviewed in lower GI clinic. \u00a0A colonoscopy was performed but was incomplete as the colonoscope could not be passed beyond the splenic flexure due to looping. A CT colonography at the time showed malrotation of the midgut. The stool test for faecal calprotectin and faecal immunochemical test led to urgent referral which threw light on the diagnosis.Original case study from presentation to GP, investigation like colonoscopy and subsequent CT colonogram.Original case study from practice.Presentation in subacute malrotation may be atypical and difficult to diagnose. The case was discussed in practice clinical meeting for shared learning.Malrotation occurs in approximately 1 in 500 births and usually presents during childhood. In rare cases, such as the one presented here, the patient may live well into adulthood without the diagnosis being made. In these cases, the patient tends to have subacute presentation of symptoms. This patient had several gastro-intestinal investigations in the past but none of them resulted in the diagnosis. This is likely due to intermittent malrotation, with investigations done during periods where the rotation was normal.This is an interesting and novel case where malrotation was found to be associated with possible inflammation and microvascular changes, resulting in raised faecal calprotectin and positive FIT test.<\/p>\n","protected":false},"template":"","class_list":["post-20277","wsa_session","type-wsa_session","status-publish","hentry","description-off"],"_links":{"self":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/wsa_session\/20277","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/wsa_session"}],"about":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/types\/wsa_session"}],"wp:attachment":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/media?parent=20277"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}