A Review of Thirty‐nine Cases

Abstract

Summary A series of 39 cases of small intestine volvulus occurring in bowel with a normal mesentery is discussed. Thirty‐three involved the ileum, 5 the jejunum and one the whole of the small bowel. They were able to be divided into three groups according to the presence or not of a predisposing cause. In Group 1, consisting of 16 cases, there was no apparent cause at all. In Group 2, with 8 cases, the predisposing cause was an old, tough fibrous band running from the apex of the involved loop of bowel to the abdominal wall. In the 15 cases of Group 3, the predisposing cause was due to acquired adhesions, either inflammatory or post‐operative, and in one instance neoplastic. Symptoms and signs are discussed with particular reference to shock. Roughly, there were two main types, the slowly twisting type of volvulus and the quickly twisting type, the latter of which is highly dangerous when diagnosis is delayed. The mortality rate was high (14 of 39 cases dying), due mainly to late diagnosis with consequent delay in hospitalization and treatment. However, there were only 2 deaths in the last 14 cases and one was not actually due to the volvulus. The follow‐up disclosed no recurrence of the volvulus in any instance.