A rare case of adult primary jejunal volvulus

Takatsuka, Mio; Shah, Mohammad Ali; Dharmarajah, Brahman; Brightwell, Robert; Damani, Nizar

doi:10.1136/bcr.09.2009.2242

Cited by 2 publications

(9 citation statements)

References 9 publications

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“…Midgut volvulus occurs when the bowel loop twist more than 180° around its own mesenteric vascular pedicle [8]. This coiling can lead to partial or complete mechanical obstruction [11] with or without the interference of its blood circulation [12]. Volvulus of the SB is rare and most commonly it involves the sigmoid colon [7], [13].…”

Section: Definitionmentioning

confidence: 99%

“…PAR is rarely helpful due to its nonspecific findings [18], [30], [41]. It can also, neither distinguish viable from a nonviable bowel nor identify volvulus as a cause [12].…”

Section: B Plain Abdominal Radiograph (Par)mentioning

confidence: 99%

“…Upper git fluoroscopic is mainly advised when malrotation is suspected in children [30] and if SBV is present it will show the characteristic corkscrew appearance [30], [41]. However, this test is time-consuming and many a time poorly tolerated when associated with SBV [9] and do not allow rapid diagnosis [12].…”

Section: Fluoroscopy Imaging Of Upper Gitmentioning

confidence: 99%

“…CT scan is the investigation of choice for SBV [5], [8] with a sensitivity of 60 to 100% [5], [6], [12] and specificity of 90 to 95% [12]. The bowel wrapping around the SMA creates the typical whirl pattern [43] which is the characteristic feature of SBV in CT scan [5], [12]. It is present in 75% of cases with SBV [12].…”

Section: E Cect Abdomen Scan (Ct Scan)mentioning

confidence: 99%

“…The bowel wrapping around the SMA creates the typical whirl pattern [43] which is the characteristic feature of SBV in CT scan [5], [12]. It is present in 75% of cases with SBV [12].…”

Section: E Cect Abdomen Scan (Ct Scan)mentioning

confidence: 99%

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Small Bowel Volvulus In Adult: A Review Of Literature

Shyam

2020

EJMED

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A Small bowel volvulus is a rare entity where the small bowel loop twists around its own mesentery. These twisting may produce a mechanical obstruction, vascular compromise, or both. In North America and Western Europe, the annual incidence of small bowel volvulus is 1.7 to 5.7 cases per 100,000, but much higher rates of 24 to 60 cases per 100,000 have been observed in Africa, Asia, the Middle East, and India. Small bowel volvulus can be classified as primary and secondary subtypes. In primary variety, there is no known cause whereas secondary variety occurs due to the presence of predisposing lesions, either congenital or acquired of which postoperative adhesion is the most common responsible factor. The most commonly accepted explanation for the initiation of primary small bowel volvulus is the abnormal bowel peristalsis generated due to the sudden overfilling of the empty bowel loop with a large portion of meal after prolong fasting. Secondary small bowel volvulus is commonly seen in the elderly population with mixed gender distribution. There are no specific clinical features or laboratory findings and a high index of suspicion is required to reach a diagnosis. Abdominal pain is the most common presenting feature of small bowel volvulus. CT scan is the investigation of choice and a whirl sign is the characteristic finding of bowel volvulus. Urgent Surgical exploration is the treatment of choice to prevent complications due to vascular compromise. Although small bowel volvulus is rare, it has a mortality rate between 9% and 35%, which can reach up to 100% if associated with bowel necrosis.

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Section: Definitionmentioning

confidence: 99%

“…PAR is rarely helpful due to its nonspecific findings [18], [30], [41]. It can also, neither distinguish viable from a nonviable bowel nor identify volvulus as a cause [12].…”

Section: B Plain Abdominal Radiograph (Par)mentioning

confidence: 99%

Section: Fluoroscopy Imaging Of Upper Gitmentioning

confidence: 99%

Section: E Cect Abdomen Scan (Ct Scan)mentioning

confidence: 99%

“…The bowel wrapping around the SMA creates the typical whirl pattern [43] which is the characteristic feature of SBV in CT scan [5], [12]. It is present in 75% of cases with SBV [12].…”

Section: E Cect Abdomen Scan (Ct Scan)mentioning

confidence: 99%

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Small Bowel Volvulus In Adult: A Review Of Literature

Shyam

2020

EJMED

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Gastric Signet Ring Cell Adenocarcinoma Presenting as Intermittent Volvulus of Small Bowel: A Case Presentation and Review of the Literature

Aqsa¹,

Droubi²,

Almoussawi³

et al. 2022

Cureus

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Signet ring cell carcinoma (SRCC) is an uncommon and poorly differentiated tumor. It arises mostly in the gastrointestinal tract. The incidence of gastric SRCC has increased in the past few years. Volvulus is the twisting of the bowel around its mesentery. It is classified as either primary or secondary. It is relatively common in the cecum and sigmoid colon. Volvulus of other parts of the gastrointestinal tract is relatively rare. Herein, we present a case of small bowel volvulus (SBV) secondary to advanced gastric SRCC with peritoneal carcinomatosis. The patient had presented with nausea and vomiting. Initial computed tomography (CT) scan of abdomen unveiled jejunal volvulus. SBV resolved spontaneously on a repeat CT scan. Enteroscopy with histopathology confirmed the diagnosis of gastric SRCC, which turned to be metastatic to peritoneum on laparoscopy. We believe our case is unique due to the rarity of advanced gastric SRCC presenting as secondary jejunal SBV without appreciated gastric mass on imaging.

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A rare case of adult primary jejunal volvulus

Cited by 2 publications

References 9 publications

Small Bowel Volvulus In Adult: A Review Of Literature

Small Bowel Volvulus In Adult: A Review Of Literature

Gastric Signet Ring Cell Adenocarcinoma Presenting as Intermittent Volvulus of Small Bowel: A Case Presentation and Review of the Literature

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