Intestinal volvulus. Case report and a literature review

Primary small bowel volvulus: surgical treatment dilemma

“…The Noble procedure of plicating bowel loops in a zigzag pattern, first described in 1937, is now largely only of historical significance due to unpredictable success, high incidence of mortality, prolonged ileus, wound infection and fistula formation . Modification of this technique with plication of mesentery, rather than the bowel directly, results in increased incidence of vascular injury . Baker’s tube insertion has similarly failed to become popularized due to high recurrence rate and risk of complications.…”

Primary small bowel volvulus: A case report and literature review

“…Enteropexy is a therapeutic option but presents the risk of fistula formation [ 2 ]. Plication of the mesentery, instead of the bowel, results in an increased risk of vascular injury [ 18 , 19 ]. Some authors suggest a systematic prophylactic surgical resection, although this increases postoperative morbidity and lengthens the hospital stay [ 4 , 20 ].…”

Small Bowel Volvulus In Adult: A Review Of Literature

“…The most common presenting feature of SBV is abdominal pain [14], [18], [24]. The severity of the pain is directly related to the level of vascular occlusion and not to the level of intestinal obstruction, and the intensity of the pain does not correspond with clinical findings, as only 26% of the patients present with peritoneal signs [37]. Common clinical manifestations in order of frequency are abdominal pain (94 to 100%), nausea or vomiting (83 to 100%), distension (55 to 100%), peritoneal irritation (14 to 26%).…”

“…J. Santin-Rivero et al stated that leucocytosis is present in 66% of the patients with mesenteric torsion but leucocytes count of over 10,000/cm3 was invariably present in 100% of the patients who developed bowel necrosis [37]. C. L. N. Tsang et al reported that among biochemical markers, an elevated lactate level can indicate mesenteric ischemia or necrosis but this too can be normal in the presence of necrosis [1].…”

“…The bowel wall is sutured with catgut. In the McCarthy modification of Childs-Phillips procedure, instead of suturing the SB loops, the mesentery is joined by sutures in a U shape perforating the mesentery proper 3 or 4 cm away from the mesenteric border of the bowel loops [37]. There are many techniques and variations hence it's solely the surgeon's decision based on his skills and experience.…”