Small bowel volvulus (SBV) due to multiple adhesion in the small intestine: A case report

Abstract

Introduction: Small bowel volvulus (SBV) is a rare but significant cause of small intestinal obstruction. Ischemia or even infarction is frequently the result. Morbidity and death rates rise when surgical intervention and diagnosis are delayed. Volvulus is a special form of mechanical intestinal obstruction. It happens when a loop of small intestine twists abnormally around the axis of its mesentery. An acute abdomen is a clinical presentation. The bowel itself may become constricted, strangulation of the blood supply, or both may be the source of the symptoms. Case Description: A-49-year old female patient was delivered to the emergency department because of severe pain around her abdomen that lasted for one day with a bloated abdomen. Other symptoms she complained of were nausea, vomiting, fever and constipation since one day before hospitalization. She was transferred to the medical ward and initially diagnosed with abdominal pain due to severe dyspepsia. After four days, her complaints were not improved, and she was diagnosed with intraabdominal obstruction and decided to undergo an emergency laparotomy. During surgery, there was a small bowel volvulus due to multiple adhesion in the small intestine, which caused all of her symptoms. After total 8 days of hospitalization, the patient was finally discharged. Conclusion: Diagnosing SBV can be difficult, especially if the sign of ileus obstruction is not yet fully developed. Early diagnosis and suspicion are pivotal in SBV because a delay in the surgical treatment can be disastrous.