Small bowel volvulus secondary to post appendectomy adhesion band

Abstract

A 66-year-old woman was admitted to the emergency department with a complaint of severe abdominal pain, nausea, and vomiting. She had a history of previous appendectomy 36 years ago. The abdominal examination revealed moderate distension and rebound tenderness. The white cell count revealed a leukocytosis (35.500/mm 3 ). Abdominal computerized tomography (CT) revealed segmental intestinal dilatation. At laparotomy, a twisted jejunoileal segment 50 cm in length was twisted around a tight adhesion band starting from the appendocecal peritoneum to the small bowel mesentery. Segmental jejunoileal resection and primary end-to-end anastomosis was performed. The patient was discharged uneventfully on the nineth day of admission.A 48-year-old woman was admitted to the emergency department with severe abdominal colicky pain. She had a history of previous appendectomy due to perforated appendicitis 18 years ago. Abdominal examination revealed extreme distention and rebound tenderness. She had a leukocytosis of 18.400/mm 3 . Abdominal CT showed diffuse intraabdominal fluid accumulation. Laparotomy was performed and an approximately 30 cm ileal volvulus was discovered around an adhesive band beginning from underneath the appendectomy incision to the small bowel mesenteric root (Figure 1). Small bowel volvulus secondary to post appendectomy adhesion bandApendektomi sonras› geliflen adezyon band›na ba¤l› incebarsak volvulusu F Fi ig gu ur re e 1 1. . Laparotomy showed a twisted small bowel segment and compressed by adhesive band.