Precipitous decline of gravid patient with congenital small bowel malrotation.

Congenital small bowel malrotation is an uncommon cause of ischemic bowel. There are only a few case reports highlighting this condition in gravid patients. We report a 33-year-old primigravida at 27 weeks who presented to the emergency department with diffuse abdominal pain. Although initially stable, she experienced a rapid calamitous decline. On laparatomy she was diagnosed with congenital small bowel malrotation. Intraabdominal catastrophes must always be considered as a possible etiology of nonobstetrical abdominal pain in pregnant women.