Diagnostic Uncertainty in a Case of Heterotaxy Leading to Intestinal Malrotation and Volvulus

We present the case of a baby with vomiting and constipation. The diagnostic tests revealed an inverted stomach, the absence of superior mesenteric vein visualization, and an elongated superior mesenteric artery, leading to the diagnosis of malrotation with situs ambiguous. Exploratory laparotomy with the Ladd's procedure was performed, and the child recovered well in the neonatal ICU. The case presented with diagnostic uncertainty in the face of vague symptoms, highlighting the need for a suspicion of malrotation and volvulus in neonates. With limited guidelines on diagnostic tests, this requires reliance on the surgeon's judgment, potentially causing delays in detecting emergent conditions like situs ambiguous leading to malrotation and volvulus.