Laparoscopic Ladd Procedure for Adult Malrotation of the Midgut with Cocoon Deformity: Report of a Case

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Abstract
Intestinal malrotation of the midgut is well documented in infants and children but rare in adults. Most adults with intestinal malrotation are asymptomatic, and the anomaly is found incidentally at laparotomy. Classically, the Ladd procedure via a laparotomy is the treatment of choice for patients with symptomatic malrotation. Laparoscopic Ladd procedures have been described in the pediatric literature, but little is known of its efficacy and applicability in adults. We present the case of a symptomatic adult patient found to have malrotation of the midgut with a cocoon deformity, a rare anomaly, that was treated successfully by a laparoscopic Ladd procedure, and we discuss the role of laparoscopy in this entity.