Malrotation of the intestine signifies a sequence of abnormal rotation of intestine during the fetal life. This phenomenon is attributed to incomplete or abnormal rotation of the intestine on axis to the superior mesenteric artery and abnormal band formation in the midgut. Malrotation of midgut is considered as a rare occurrence especially in the younger adult. The patient seen by us was a fifteen year old middle school girl who has been suffering from severe abdominal pain associated with nausea and vomiting four days prior to the admission. She was a rather small stature and slightly undernourished. Her vital sign were within normal range, but mild grade of fever. She had had acute pancreatitis a year ago before admission. She was well oriented, but somewhat dehydrated on admission. The routine laboratory examination and various biochemical studies in sera were essentially normal. Chest x-ray (P-A) showed normal, but the simple scout film of the abdomen disclosed marked gas distention below both hypochondrial regions. There was transient improvement by the medical supportive management, but she became worse after the eighth hospital day. Upper GI studies by swallowing barium meal disclosed that esophagus was normal, but there was some intragastric fluid with the circular like folds in the pyroric antrum, and the extreme narrowing of the second portion of the duodenum. On the tenth hospital day, the ladd's procedure of operation was performed successfully for her chronic intestinal obstruction due to the congenital malrotation. Following the surgery, the condition was good and she discharged on eleventh hospital days.