Small-Intestinal Volvulus  

Oleh:

Hong, Ming-Yuan ; Chi, Chih-Hsien

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 365 no. 04 (Jul. 2011), page 358.
Topik: Abdominal Pain; Volvulus
Fulltext: Small-Intestinal Volvulus.pdf (372.28KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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A 67-year-old man presented to the emergency department with acute abdominal pain, which had started 3 hours earlier. On physical examination, the abdomen was distended and tender to palpation. The levels of serum lipase and lactate were within normal limits, as were the white-cell count and hematocrit. The abdominal pain persisted and progressed in severity even after the administration of analgesic drugs. Abdominal computed tomography with intravenous contrast material revealed twisting of mesenteric pedicles (arrows), with the superior mesenteric artery encircled by the superior mesenteric vein in a 360-degree clockwise rotation. This radiologic finding is known as the “whirl sign,” which occurs when bowel loops rotate around a fixed point of obstruction, suggesting intestinal volvulus. An emergency laparotomy was performed, which confirmed the diagnosis of small-bowel volvulus. A jejunal diverticulum with an adhesion band located 40 cm below the ligament of Treitz was identified as the cause of this volvulus. The patient underwent reduction of the volvulus and resection of the jejunal diverticulum. He subsequently made a full recovery.

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