A case of volvulus of the small intestine in adult with chylous ascites and mesenteric edema

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  • 腸間膜乳び浮腫および乳び腹水を呈した成人原発性小腸軸捻転の1例
  • 症例 腸間膜乳び浮腫および乳び腹水を呈した成人原発性小腸軸捻転の1例
  • ショウレイ チョウ カンマクニュウビ フシュ オヨビ ニュウビ フクスイ オ テイシタ セイジン ゲンパツセイ ショウチョウジク ネンテン ノ 1レイ

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Abstract

The patient was a 22-year-old man who visited the emergency department complaining of sudden abdominal pain and vomiting three hours after meals. Abdominal CT revealed a “whirl-like sign”. We diagnosed the case as volvulus of the small intestine. At laparotomy, a moderate amount of chylous ascites was observed in the peritoneal cavity. The small intestine had rotated 270-360°counterclockwise around the superior mesenteric artery. The mesentery of the small intestine from the ligament of Treitz to 90-660 cm was presented with chylous edema. The volvulus was rotated back to the correct position without bowel resection. The patient's post-operative course was uneventful. One month after discharge, abdominal CT and abdominal ultrasonography showed improvement of the mesenteric edema. Volvulus of the small intestine in adults with chylous ascites and chylous mesenteric edema is rare and only four cases have been reported.

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