Recurrent intestinal volvulus in midgut malrotation causing acute bowel obstruction: A case report

被引:9
作者
Sheikh, Fayed [1 ]
Balarajah, Vickna [1 ]
Ayantunde, Abraham Abiodun [1 ]
机构
[1] Southend Univ Hosp, Dept Surg, Prittlewell Chase, Southend On Sea SS0 0RY, Essex, England
关键词
Gut volvulus; Intestinal malrotation; Acute bowel obstruction; Computerised tomography scan; Laparotomy;
D O I
10.4240/wjgs.v5.i3.43
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Intestinal malrotation occurs when there is a disruption in the normal embryological development of the bowel. The majority of patients present with clinical features in childhood, though rarely a first presentation can take place in adulthood. Recurrent bowel obstruction in patients with previous abdominal operation for midgut malrotation is mostly due to adhesions but very few reported cases have been due to recurrent volvulus. We present the case of a 22-year-old gentleman who had laparotomy in childhood for small bowel volvulus and then presented with acute bowel obstruction. Preoperative computerised tomography scan showed small bowel obstruction and features in keeping with midgut malrotation. Emergency laparotomy findings confirmed midgut malrotation with absent appendix, abnormal location of caecum, ascending colon and small bowel. In addition, there were small bowel volvulus and a segment of terminal ileal stricture. Limited right hemicolectomy was performed with excellent postoperative recovery. This case is presented to illustrate a rare occurrence and raise an awareness of the possibility of dreadful recurrent volvulus even several years following an initial Ladd's procedure for midgut malrotation. Therefore, one will need to exercise a high index of suspicion and this becomes very crucial in order to ensure prompt surgical intervention and thereby preventing an attendant bowel ischaemia with its associated high fatality. (C) 2013 Baishideng. All rights reserved.
引用
收藏
页码:43 / 46
页数:4
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