Correspondence to Author: Parveen Malhotra, Sandeep Kumar, Harman Singh, Senti, Yogesh Sanwariya, Rahul Siwach, Pranav Malhotra, Anuj Sharma. 

Department of Medical Gastroenterology, PGIMS, Rohtak, Haryana, VMMC & Safdarjung Hospital, New Delhi, India

DOI: 10.52338/jjogastro.2025.5194

Abstract:

Introduction: Celiac disease has immune based autoimmune disease which is noticed in genetically predisposed persons and is due to gluten allergy. It was initially thought that it is disease of children and presents with typical or classical symptoms associated with gastro-intestinal tract like pain abdomen, diarrhea or constipation. Now, it has been proven that it is commonly seen in adult age also and in half of cases presents with atypical or unclassical symptoms which are mainly due to nutrients or minerals deficiency. Thus, patients can have neurological, psychiatric, dental or reproductive problems. Intestinal malrotation is seen in many cases but in association with celiac disease is rare and very few cases are reported in literature.
Case Report: We report a case of sixteen-year-old child who was known case of celiac disease for last three years but was intermittently taking gluten in diet. He presented with severe pain abdomen for last two months and his serum IgATTG antibody were raised to 80 I.U. He was restarted on strict gluten restriction but pain abdomen did not subside. Moreover, his pain abdomen was severe, requiring injectable analgesics intermittently. His pain abdomen was different which is usually seen in celiac disease i.e. generalized and dull aching. His ultrasonogram abdomen was normal but in view of non-resolution of pain abdomen, he was subjected to contrast enhanced computed tomography scan which showed intestinal malrotation, all his small bowel was on left side and large bowel was on right side. He was advised surgical consultation and has yet to come for review after surgical consultation.
Conclusion: Malrotation can be seen more commonly than expected. Even though it has traditionally been thought as a disease of the infants, it can present later in life and tends to have non-specific gastrointestinal symptoms. Clinicians need a high index of suspicion when assessing patients with these symptoms which poses more challenge in background of celiac disease..

Keywords: Celiac disease, Gluten, Intestinal malrotation, Serum IgATTG antibody, Endoscopy

Citation:

Dr.Parveen Malhotra, Celiac Disease with Intestinal Malrotation - A Rare Phenomenon.Japanese Journal of Gastroenterology 2025.