Occurs during midgut development and rotation with anomalous positing of the small intestine, cecum and ascending colon.
Cecum remains in the right upper quadrant or in the left abdomen and the duodenal-jejunal junction remains to the right of the midline.
The presence of abnormal peritoneal attachment can cause obstruction of the duodenum in infancy and early adulthood.
In malrotation, the lack of gut fixation to the retroperitoneum and narrow midgut mesenteric base predisposes patients to midgut volvulus, which occurs when the duodenum or colon twist around this mesenteric base.
Can lead to midgut volvulus when the malrotated intestine twists on the axis of the superior mesenteric artery impairing intestinal blood flow.
Midgut volvulus may occur during the first year of life.