Presentation of Small Bowel Volvulus in East Africa: A Case Report

Abstract

Introduction: Small bowel volvulus(SBV) is a benign gastrointestinal surgical condition characterised by torsion of a segment of the small bowel along its mesenteric axis. Because the clinical presentation is similar to acute mesenteric ischaemia, obtaining a preoperative clinical diagnosis is difficult. As a presenting surgical cause of small bowel obstruction in developing countries, it has contributed significantly to the burden.The purpose of this case report was to discuss a typical case of small bowel volvulus in a developing country and emphasise the significance of resuscitation and early surgical intervention. Presentation of Case: A 35-year-old woman was admitted to the hospital after complaining of colicky central abdominal pain for three days. She described a long period of fasting followed by a sudden ingestion of food. Her abdomen was moderately distended with minimal tenderness on physical examination. The results of the laboratory tests were normal, and a plain abdominal X-ray revealed features suggestive of small bowel obstruction. Following resuscitation, the patient was taken to the operating room for a laparotomy, where SBV was discovered. The omental band adhesion was cut, the volvulus was untwisted, and the small bowel was all viable. The patient's postoperative recovery was uneventful. Discussion: SBV is more common in Africa, Asia, and the Middle East than in the Western world. Secondary SBV is more common in older people, whereas primary SBV is more common in children. The most common symptoms of SBV are abdominal pain, distention, and vomiting.  The mortality rate due to SBV has been found to be decreasing with early diagnosis due to abdominal CT scanning. This decrease in mortality is due to a decrease in the incidence of SBV gangrene. Conclusions: Small bowel volvulus should be considered a likely diagnosis in a patient with stomach discomfort and symptoms of small bowel obstruction because of the high mortality and varied presentation. SBV morbidity and death can be reduced with early surgical intervention.