Midgut volvulus in an adult without significant intestinal obstruction: A case report.

Autor: Adhikari R; National academy of medical sciences, Bir hospital, Kathmandu, Nepal., Paudel M; National academy of medical sciences, Bir hospital, Kathmandu, Nepal., Sitaula S; National academy of medical sciences, Bir hospital, Kathmandu, Nepal.
Jazyk: angličtina
Zdroj: Radiology case reports [Radiol Case Rep] 2024 May 15; Vol. 19 (8), pp. 3200-3204. Date of Electronic Publication: 2024 May 15 (Print Publication: 2024).
DOI: 10.1016/j.radcr.2024.04.039
Abstrakt: Mid gut volvulus is a rare clinical presentation in adults though it frequently occurs in infants and children. We report a case of 30 years male (post renal transplant patient) who presented with symptoms of abdominal pain, nausea and vomiting for 3 days. After demonstration of twisting of bowel loops around mesenteric vessels on Ultrasonography (USG). Contrast enhanced computed tomography (CECT) abdomen was done which showed small bowel malrotation, inverted relation of Superior mesenteric artery-Superior mesenteric vein and whirl pool sign of midgut volvulus. However, no significant bowel obstruction was noted. Patient underwent explorative laparotomy with ladd's procedure. Post-operatively, it was uneventful. Patient became symptoms free and was discharged after 5 days of surgery. Intestinal malrotation is a congenital abnormality that arises from disrupting the 270◦ counterclockwise midgut rotation during the embryonic period. In our case malrotation was predisposing factor for volvulus. CECT abdomen is the imaging procedure of choice in adults. Ladd's procedure is the treatment of choice in symptomatic patients though it remains controversial in asymptomatic patients. Though midgut volvulus is rare in adults, it should be kept as differential in adults with symptoms of intestinal obstruction and workup should be done accordingly.
(© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze: MEDLINE