Small bowel volvulus; retrospective case series

Abstract

Objective: Diagnosis of small bowel volvulus is challenging. Early and accurate diagnosis is important for prevention of bowel necrosis, and for reducing morbidity and mortality. In this report, we aimed to present seven cases with small intestine volvulus who were admitted to the emergency department and to discuss this condition with the literature.

Methods: Seven patients who were admitted with acute abdominal and/or intestinal obstruction and diagnosed with small bowel volvulus during 2007-2012 were evaluated for demographics, physical examinations, laboratory tests, operation findings, and outcome.

Results: Massive bowel resections were needed in two patients at surgery. In one of these patients, no underlying abnormality was found, ending with mortality in the intensive care unit. In the other patient, the cause of volvulus was adhesions. This patient was admitted into the intensive care unit for 15 days. In the remaining patients, the cause of volvulus was Meckel's diverticulum in five patients and adhesions in three patients.

Conclusion: Diagnosis of small bowel volvulus is a challenging situation. Generally, the diagnosis is made during emergency laparotomy due to acute abdomen or intestinal obstruction. Because of this challenging condition, massive bowel resection is required in some cases. Early diagnosis and treatment of small bowel volvulus are the most important factors in decreasing mortality and morbidity.