Purpose) Segmental small bowel volvulus without malrotation is a different disease entity from midgut volvulus. Unlike midgut volvulus with malrotation, segmental small bowel volvulus shows rapid progression to ischemic necrosis and bowel perforation....
Purpose) Segmental small bowel volvulus without malrotation is a different disease entity from midgut volvulus. Unlike midgut volvulus with malrotation, segmental small bowel volvulus shows rapid progression to ischemic necrosis and bowel perforation. This study was performed to analyze the clinical characteristics of patients with segmental small bowel volvulus.
Subject and Methods) A retrospective review of 6 patients who had segmental small bowel volvulus and received operation at the Pusan National University Hospital from 1996 to 2007 was done.
Results) There were 6 cases of segmental small bowel volvulus. There were 2 males and 4 females with female predominance. Mean gestational age was 34^(+6) weeks and mean birth weight was 2593.7gm. Five patients had symptoms within 48hour after birth; the remaining case had symptom at 63 days. Unfortunately all cases were misdiagnosed, their preoperative diagnosis was ileal atresia and necrotizing enterocolitis. Five patients received 1st operation at 5.5 days after birth; the remaining case received at 67 days. The lesion site was ileum in 4 cases and jejunum in 2 cases. Ischemic necrosis of affected bowel was seen in all cases and perforation was seen in 3 cases. Segmental resection of bowel was performed in all cases and mean length of resected bowel was 33.8cm. There was no mortality case.
Conclusions) Segmental small bowel volvulus shows rapid progression but proper diagnostic attempts and early surgical management will show a good result.