肠旋转不良（IM）是成人中一种罕见的先天性异常，尽管在婴儿期更为常见。这种情况起源于胚胎发育期间，由于中肠围绕肠系膜上血管的不完全旋转。本案例研究的主要目的是强调外科医生在腹腔镜胃手术期间认识和识别这种先天性异常的重要性，以避免严重并发症。 一名 45 岁男性到诊所就诊，主诉持续两周的模糊上腹疼痛。几个月。患者接受了全面的临床评估，包括实验室检查、内窥镜检查和放射成像。诊断检查显示早期胃癌。顺便说一句，放射学研究还表明小肠先天性不旋转。鉴于患者先天性解剖异常，采用反向 C 形 Roux-En-Y 肢体重建进行腹腔镜全胃切除术。术后恢复顺利，病情稳定出院。2年随访，患者情况良好，未出现与吻合形式相关的并发症，病理结果与普通患者相当。非旋转小碗。肠旋转不良是成人中一种罕见的无症状先天性异常。在腹腔镜胃手术期间，外科医生应识别这种异常以优化手术方法，特别是在吻合形成期间。肠旋转不良的准确识别和适当处理对于减轻潜在的术后并发症至关重要，包括扭转、梗阻、张力和吻合口漏。

Intestinal malrotation (IM) represents a rare congenital anomaly in adults, although it is more common during infancy. This condition originates during embryonic development due to incomplete rotation of the midgut around the superior mesenteric vessels. The primary aim of this case study is to emphasize the importance of surgeon awareness and recognition of this congenital anomaly during laparoscopic gastric surgery to avoid serious complications.A 45-year-old male presented to the clinic with a complaint of vague epigastric pain for two months. The patient underwent a comprehensive clinical evaluation, including laboratory tests, endoscopic examination, and radiological imaging. The diagnostic workup revealed early-stage gastric cancer. Incidentally, radiological studies also demonstrated a congenital non-rotation of the small bowel. Given the patient's congenital anatomical anomaly, a laparoscopic total gastrectomy was performed employing a reversed C-shaped Roux-En-Y limb reconstruction. Postoperative recovery was uneventful, and the patient was discharged in stable condition.The patient was doing well at the 2-year follow-up, there were no complications related to the form of anastomosis, and the pathological result was comparable to that of patients with non-rotating small bowls.Intestinal malrotation is an uncommon asymptomatic congenital abnormality in adults. During laparoscopic gastric surgery, the surgeon should identify this anomaly to optimize surgical approaches, particularly during anastomosis formation. Accurate identification and appropriate management of intestinal malrotation are crucial to mitigate potential postoperative complications, including twisting, obstruction, tension, and anastomosis leak.