Spontaneus small bowel volvulus in an adult. Case report and review of the literature

Emanuele Grasso, Leander Sciolli
Annali Italiani di Chirurgia 2011, 82 (5): 413-6

BACKGROUND: We present a case of spontaneus small bowel volvulus in an adult patients who presented to the emergency department. In this case we had no obvious precipitating factors.

AIMS: A man of 72 years, was transferred to our hospital after being examined and diagnosed with acute pain. Over the past two years has had four episodes of sharp epigastric pain radiating to the back half with associated nausea and vomiting. He is an alcoholic and heavy smoker. His medical history, blood, urine and biochemical data were all non-cotributory. An abdominal CT angiography, we noticed a swirling mass of mesenteric and small bowel with adjacent around the superior mesenteric artery.

METHODS: A case of spontaneus volvulus of the small intestine in an adult with a review of the literature is reported.

CONCLUSIONS: SBV is an uncommon but potentially serious cause of small bowel obstruction in Western countries, carrying an overall mortality rate of 10% to 35%. In the presence of gangrene, mortality is usually 40% or greater. Physicians should consider, in patients with obstruction of the small intestine where their pain is excessive and does not respond to treatment with narcotics analgesic the possibility of volvulus of the mesentery. If the diagnosis is suspected emergency surgical is necessary, conservation measures usually result in a higher rate of gangrene. Although no studies have identified an optimal surgical treatment, resection and primary anastomosis has been recommended in all cases.

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