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Revista chilena de cirugía

On-line version ISSN 0718-4026

Abstract

LOPEZ-CASILLAS, Nelson; CUEVAS-GONZALEZ, Aarón  and  ZAMBRANO-LECHUGA, Rodolfo. Primary volvulus of ileum: A rare form of intestinal obstruction in the adult. Case report and literature review. Rev Chil Cir [online]. 2018, vol.70, n.3, pp.285-290. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2017.03.009.

Background

The small bowel volvulus is caused by the abnormal rotation of the small intestine around the axis of its own mesentery. This can lead to intestinal obstruction, ischemia, infarction or perforation.

Clinical case

A 71-year-old male patient with an acute abdominal pain, suspicious for a bowel occlusion, performed a surgical exploration, finding small bowel volvulus at the ileocecal valve level, with necrosis and ischemia of 280 cm of the small intestine, resulting in intestinal resection and terminal ileostomy. Still preserving 320 cm of viable small intestine from the duodenojejunal angle, with a satisfactory evolution.

Discussion

Small bowel volvulus is an uncommon entity, and a life-threatening surgical emergency, that should be suspected in all patients with abrupt abdominal pain and signs of bowel obstruction, without previous abdominal surgery or other obvious causes. Early diagnosis and immediate surgical intervention are key factors associated with a better prognosis for this group of patients.

Keywords : intestinal volvulus; intestinal obstruction; intestinal ischemia.

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