Vomito da malrotazione intestinale a esordio tardivo

Intestinal malrotation (IM) is a rare congenital alteration of the embryonal development of the bowel that typically presents in the first year of life. The Authors introduce the case of a 5 years old child affected by a chromosomal disorder (partial trisomy 4q and partial monosomy 7p in balanced maternal translocation) with a two-month-history of recurrent gastric vomiting and abdominal distension without pain or alterations in blood tests. The patient underwent abdominal radiography, ecography and upper gastrointestinal barium examination that showed multiple air-fluid levels, marked distension of stomach, duodenum and first tract of jejunum and a Treitz in abnormal position. IM was confirmed by surgery and intestinal derotation and duodenoplastic were performed. IM should be considered as a differential possibility in the diagnosis of abdominal disorders in older children and adults.