A Case of Intestinal Volvulus Having Basilar Mesenteric Defect Without Intestinal Malrotation

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  • Kinashi Takanori
    Miyazaki University School of Medicine, Surgical Oncology and Regulation of Organ Function
  • Mukai Motoi
    Miyazaki University School of Medicine, Surgical Oncology and Regulation of Organ Function
  • Torikai Motofumi
    Miyazaki University School of Medicine, Surgical Oncology and Regulation of Organ Function
  • Kondo Kazuhiro
    Miyazaki University School of Medicine, Surgical Oncology and Regulation of Organ Function
  • Chijiiwa Kazuo
    Miyazaki University School of Medicine, Surgical Oncology and Regulation of Organ Function

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Other Title
  • 腸回転異常症を伴わないbasilar型小腸軸捻転症の1例
  • 症例報告 腸回転異常症を伴わないbasilar型小腸軸捻転症の1例
  • ショウレイ ホウコク チョウ カイテン イジョウショウ オ トモナワナイ basilarガタ ショウチョウジク ネンテンショウ ノ 1レイ

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Abstract

The patient is a two-month-old boy. He was referred to us for evaluation of bloody stool and bilious vomiting at three days of life. An upper GI series and barium enema showed no evidence of intestinal malrotation. He became well and left hospital at 48 days of life. At 74 days of life, his bilious vomiting recurred. Abdominal computed tomography (CT) and color Doppler ultrasonography demonstrated intestinal volvulus. He underwent surgery. Almost all of the small intestine was twisted clockwise by 1,080 degrees. The ligament of Treitz was in its normal position, as was the cecum. He was diagnosed as having an intestinal volvulus with basilar mesenteric defect. Because the base of the small bowel mesentery was very narrow, he underwent Ladd's procedure to prevent further episodes of volvulus. The neonates with basilar mesenteric defects have similar clinical presentations with midgut volvulus secondary to intestinal malrotation. Even when there is no evidence of intestinal malrotation, we should perform ultrasonography and contrast CT as well as a radiographic contrast study to rule out intestinal volvulus with basilar mesenteric defect.

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