# Adult intestinal malrotation presenting as caecal volvulus with incidental findings of duplicate inferior vena cava and other rare abnormalities: case report

## TL;DR

A 25-year-old woman had intestinal malrotation and caecal volvulus, along with rare vascular and splenic abnormalities not previously reported together.

## Contribution

This case report documents a unique combination of intestinal malrotation, caecal volvulus, and other rare anatomical abnormalities in an adult.

## Key findings

- The patient had caecal volvulus with pneumatosis coli due to intestinal malrotation.
- Incidental findings included duplicate inferior vena cava, azygos continuation, and splenic fragmentation.
- The malformations align with polysplenia syndrome, a rare condition.

## Abstract

Intestinal malrotation and duplication of the inferior vena cava are rarely diagnosed in adult patients; however, incidence is likely underestimated as they are usually asymptomatic. These congenital malformations have been previously reported in the same patient twice but never with colonic obstruction or ischaemia. A 25-year-old female presented with nausea, vomiting, obstipation, and abdominal pain, and on computed tomography of the abdomen and pelvis was diagnosed with a caecal volvulus and pneumatosis coli associated with intestinal malrotation requiring emergency right hemicolectomy. Incidentally, the patient was noted to have duplication of the inferior vena cava, azygos continuation of the inferior vena cava, and splenic fragmentation. This constellation of symptoms has not been reported in the literature previously. The pattern of malformations follows that of polysplenia syndrome. Although rare, awareness of these malformations can be useful to clinicians.