The preoperative diagnosis of cecal volvulus (CV) is rare and difficult and emergent laparotomy is frequently performed. Here, we report a case of CV that was diagnosed by preoperative computed tomography in a patient with an intellectual disability. In addition, we demonstrate that elective laparoscopic cecopexy can be performed following conservative treatment, such as the use of an ileus tube per anus.
Malrotation is the incomplete rotation of the intestine during the fetal period. We report a case of midgut volvulus due to intestinal malrotation in a 4-year-boy. The patient was hospitalized for abdominal pain and non-biliary emesis. Biliary emesis was observed on the second day, and intestinal obstruction was suspected. Enhanced abdominal computed tomography showed that the positions of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) were reversed left and right (SMV rotation sign), with swirling of the SMV around the SMA (whirlpool sign). The diagnosis was midgut volvulus with abnormal intestinal rotation. Emergency Ladd surgery was performed on the same day. Since surgery, the patient has not re-twisted and is in good condition. The majority of such patients are diagnosed within the first year of life with symptoms of biliary emesis and bowel obstruction.Although midgut volvulus is rare in young children, it is necessary to consider the possibility.
Anomalous congenital band (ACB) is rare and difficult to identify preoperatively. Here we report a pediatric ACB case that was preoperatively suspected using computed tomography and was difficult to differentiate from omphalomesenteric duct anomaly. ACB should be considered in the differential diagnosis of acute abdomen. (J Nippon Med Sch 2017; 84: 304 307)
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