Nonrotation of the midgut in adults is a rarely encountered situation. We present a 27-year-old man with schizophrenia who had suffered from abdominal pain for 4 days. Acute perforated appendis was favored preoperatively. Dyring laparotomy, a severely inflamed appendix with perforation and also midgut nonrotation were identified. An appendectomy was performed, while no particular procedure was done for the nonrotation. The postoperative course was complicated by wound infection. Relevant literature is reviewed for the disease entity.