Rare case of midgut volvulus with malrotation in an elderly patient

A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced.

Ultra Structure of the Mid-Gut of the Third Instar Larvae of Sarcophaga Aegyptiaca (Diptera: Sarcophagidae).

The mid-gut of third instar larvae of Sarcophag aegyptiaca was divided into anterior, middle and posterior mid-gut regions. A well-developed peritrophic membrane appeared in the apical part of the anterior and middle portions of mid-gut while it is absent from the posterior portion. The microvilli differs in 3 portions, appeared as apical membrane in the anterior portion, sparse in middle portion to long slender compact microvilli in posterior portion. Numerous organelles were observed throughout the cytoplasm of the 3 portions; lipid spheres, rough endoplasmic reticulum, seceretory vesicles and mitochondria. A large apically nucleus appeared in the 3 portion of mid-gut. A basal labyrinth was observed in both anterior and posterior regions of mid-gut while it was absent in middle portion of mid-gut. Thin basement membrane was observed in the 3 portions of mid-gut of third instar larvae of Sarcophag aegyptiaca.