Primary small bowel volvulus: surgical treatment dilemma

Tam, Adrian; Phong, Jenny; Yong, Charles

doi:10.1111/ans.14967

Cited by 8 publications

(13 citation statements)

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“…Surgical fixation of small bowel is technically challenging and its long term results are not documented [6]. For secondary SBV, the underlying cause should be addressed during laparotomy [1,6]. In our case, simple derotation was done, the loaded bowel loops were decompressed and on thorough exploration of the abdomen, no secondary cause was identified.…”

Section: Discussionmentioning

confidence: 78%

“…If the bowel is necrotic, resection is needed but the management of primary SBV cases with viable bowel is controversial, the options being either resection or simple derotation, with or without fixation of the involved bowel [4,6]. Resection in viable bowel cases results in longer hospital stays with increased morbidity while derotation alone can result in recurrence rates up to 30% [6,11]. Surgical fixation of small bowel is technically challenging and its long term results are not documented [6].…”

Section: Discussionmentioning

confidence: 99%

“…Resection in viable bowel cases results in longer hospital stays with increased morbidity while derotation alone can result in recurrence rates up to 30% [6,11]. Surgical fixation of small bowel is technically challenging and its long term results are not documented [6]. For secondary SBV, the underlying cause should be addressed during laparotomy [1,6].…”

Section: Discussionmentioning

confidence: 99%

“…Emergency surgery is the treatment to be undertaken with the aim of untwisting the volvulus and re-establishing the blood flow [ 6 ]. If the bowel is necrotic, resection is needed but the management of primary SBV cases with viable bowel is controversial, the options being either resection or simple derotation, with or without fixation of the involved bowel [ 4 , 6 ]. Resection in viable bowel cases results in longer hospital stays with increased morbidity while derotation alone can result in recurrence rates up to 30% [ 6 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Small bowel volvulus (SBV) refers to the abnormal twisting of a loop of small bowel about the axis of its mesentery [ 1 – 4 ]. This results in partial or complete mechanical intestinal obstruction and eventually to bowel ischemia, necrosis, perforation and peritonitis [ 5 , 6 ]. SBV is a rare cause of small bowel obstruction accounting 1–4% cases in Western World, but up to 20–35% cases are seen in Asia, Africa and the Middle east [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Primary ileal volvulus: a rare twist in an elderly patient—case report

et al. 2020

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Background Small bowel volvulus is a rare entity and it is even rarer for the ileum to undergo torsion without any known predisposing factors. It presents as acute abdomen with features of intestinal obstruction. As it is a life-threatening condition, it should be kept as a differential for small bowel obstruction despite its rarity. Therefore, we report this case. Case report A 60-year-old gentleman presented to our emergency department with a 2-day history of worsening abdominal pain, vomiting, abdominal distension and obstipation. Exploratory laparotomy was done which revealed ileal volvulus with no predisposing factors. Derotation of the segment was done. The postoperative period was uneventful and on follow up after a month, he had a satisfying recovery. Conclusion Though primary ileal volvulus is a rare diagnosis, it should be kept in mind in any patient with small bowel obstruction with pain out of proportion and resistant to opioid management. Early diagnosis and urgent surgical intervention is the key to prevent bowel necrosis and associated morbidity and mortality.

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Section: Discussionmentioning

confidence: 78%