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Intestinal obstruction from midgut volvulus after laparoscopic appendectomy
S A Cuadra1, M E Khalife, D J Char
1Deparment of Surgery and Radiology, SUNY Stony Brook, HSC 19-020, Stony Brook, NY 11794, USA. salcuadra@yahoo.com
Surgical Endoscopy
|April 19, 2002
Summary
A 30-year-old man experienced small bowel obstruction due to acute midgut volvulus post-appendectomy. This occurred despite no initial signs of malrotation, highlighting a rare post-operative complication.
Area of Science:
- Gastroenterology
- Surgical Complications
- Abdominal Imaging
Background:
- Laparoscopic appendectomy is a common surgical procedure.
- Midgut volvulus is a rare but serious surgical emergency.
- Congenital intestinal malrotation is a known risk factor for midgut volvulus.
Observation:
- A 30-year-old male developed symptoms of small bowel obstruction 8 days after laparoscopic appendectomy.
- Initial computed tomography (CT) scans and intraoperative laparoscopy showed no evidence of congenital malrotation or existing midgut volvulus.
- The patient subsequently developed an acute midgut volvulus.
Findings:
- Acute midgut volvulus can occur post-operatively in the absence of congenital intestinal malrotation.
- Laparoscopic appendectomy may be a precipitating factor for acquired midgut volvulus.
- Delayed diagnosis of midgut volvulus can lead to significant morbidity.
Implications:
- Clinicians should maintain a high index of suspicion for midgut volvulus in patients presenting with abdominal symptoms post-laparoscopic appendectomy.
- Further research is needed to understand the mechanisms of acquired midgut volvulus.
- Early recognition and surgical intervention are crucial for favorable outcomes in post-operative midgut volvulus.