Piping often must be contorted a bit to deal with field conditions. Sometimes this means that a lateral run must rise to another elevation and shift aside to clear an obstacle. I'm not sure what is going on here but I thought it was an "interesting" field condition (in a parking garage during a recent hotel stay).
Doing so may mean that a fitting needs to rotate about the axis of the pipe run. Fittings rotate pretty easily in 90 degree increments just by clicking on the little circular rotate icon when the fitting is selected. Keep in mind that once you've connected pipes to the fitting that you'll likely lose the ability to rotate it with the little icon.When this doesn't cut it another tool might make the process a bit "easier". "Routing Solutions" exists to offer a variety of duct/pipe connection options by simply choosing two pipes or ducts. Revit will think about them for a moment and if possible offer you some choices. Like this image:
When you really need to rotate a fitting at a specific angle it gets a little "harder". You could rotate the fitting in a 3D view but making sure the origin of rotation is exactly aligned with the centerline of the pipe might be harder. The surest way is to cut a section next to the fitting temporarily so you can rotate it precisely. A bit more work but doable.
Once your fitting(s) is/are rotated then you can sketch a pipe between them in the same section view as long as you are careful to snap to the fitting connector at each fitting. The trim tool often does the job too, just get the pipes in the correct locations then trim/extend and let Revit put the fittings in.