Spontaneus small bowel volvulus in an adult. Case report and review of the literature


COD: 05_2011_413-416 Categorie: ,

Emanuele Grasso, Leander Sciolli

Ann. Ital. Chir., 2011 82: 413-416

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BACKGROUND: We present a case of Spontaneus Small Bowel Volvulus in an Adult patients who presented to the emergency
department. In this case we had no obvious precipitating factors.
AIMS: A man of 72 years, was transferred to our hospital after being examined and diagnosed with acute pain. Over
the past two years has had four episodes of sharp epigastric pain radiating to the back half, with associated nausea and
vomiting. He is an alcoholic and heavy smoker. His medical history, blood, urine and biochemical data were all noncotributory
An abdominal CT angiography, we noticed a swirling mass of mesenteric and small bowel with adjacent
around the superior mesenteric artery.
METHODS: A case of Spontaneus volvulus of the small intesine in an adult with a review of the literature is reported
CONCLUSIONS: SBV is an uncommon but potentially serious cause of small bowel obstruction in Western countries, carrying
an overall mortality rate of 10% to 35%. In the presence of gangrene, mortality is usually 40% or greater.
Physicians should consider, in patients with obstrution of the small intestine where their pain is excessive and does not
respond to treatment with narcotics analgesic the possibility of volvulus of the mesentery.
If the diagnosis is suspected emergecy surgical is necessary, conservation measures usually result in a higher rate of gangrene.
Although no studies have identified an optimal surgical treatment, resection and primary anastomosis has been
recommended in all cases.