Vólvulo primario de íleon: una rara forma de obstrucción intestinal en el adulto. Reporte de caso y revisión de la literatura

Abstract

Background: The small bowel volvulus is caused by the abnormal rotation of the small intestine around the axis of its own mesentery. This can lead to intestinal obstruction, ischemia, infarction or perforation. Clinical case: A 71-year-old male patient with an acute abdominal pain, suspicious for a bowel occlusion, performed a surgical exploration, finding small bowel volvulus at the ileocecal valve level, with necrosis and ischemia of 280 cm of the small intestine, resulting in intestinal resection and terminal ileostomy. Still preserving 320 cm of viable small intestine from the duodenojejunal angle, with a satisfactory evolution. Discussion: Small bowel volvulus is an uncommon entity, and a life-threatening surgical emergency, that should be suspected in all patients with abrupt abdominal pain and signs of bowel obstruction, without previous abdominal surgery or other obvious causes. Early diagnosis and immediate surgical intervention are key factors associated with a better prognosis for this group of patients.

Complicated sigmoid colon volvulus: case presentation

“…It is demonstrated both by the elements of the physical examination and in simple abdominal x-rays. The latter helps determine the site of the obstruction, usually discovers abnormal amounts of gas, liquid and determines if there is distention, shows air-fluid levels within the obstructed loops, which constitutes a late sign, 11,12 as was observed in the studies of this patient. Treatment is discussed in the case presentation.…”

Vólvulo intestinal como causa de abdomen agudo: Reporte de caso

“…El vólvulo intestinal secundario es el más frecuente en la cultura Occidental, puesto que el primario solo representa del 0.1% al 0.22% de los casos de vólvulo intestinal; por otro lado, en Asia y África el https://doi.org/10.55204/trc.v4i1.e300 vólvulo primario puede llegar a representar entre el 31% al 100% de los casos, probablemente debido a la dieta y hábitos que se siguen durante el periodo del Ramadán (4,15). El presente caso corresponde a una de las presentaciones más comunes en nuestra región, el vólvulo intestinal secundario, siendo las adherencias en el íleon, la anomalía subyacente.…”

“…La mayoría de los casos reportados corresponden a recién nacidos debido a malformaciones, como malrotación intestinal congénita; mientras que durante la adultez es raro y se presenta más frecuentemente en pacientes con factores predisponentes como bridas, adherencias posquirúrgicas o hernias internas (4).…”

Complicated Sigmoid Colon Volvulus. Case Presentation

“…It is demonstrated both by the elements of the physical examination and in simple abdominal x-rays.The latter helps determine the site of the obstruction, usually discovers abnormal amounts of gas, liquid and determines if there is distention, shows air-fluid levels within the obstructed loops, which constitutes a late sign, as was observed in the studies of this patient. Treatment is discussed in the case presentation [11,12]. Within surgical practice, various modalities are proposed, one of them is endoscopic treatment in the acute phase and then definitive surgery, others perform segmental resections and primary anastomoses, some authors lean towards resection and emergency Rankin colostomy [13].…”