Small bowel volvulus with jejunal diverticulum: Primary or secondary?

Area of Science:

• Gastroenterology and Surgical Innovation
• Diagnostic Imaging in Abdominal Emergencies

Background:

• Small bowel volvulus, a critical surgical emergency involving intestinal torsion, presents as primary or secondary types.
• Secondary small bowel volvulus arises from factors like adhesions, diverticula, or tumors, necessitating accurate diagnosis.

Observation:

• A 60-year-old male presented with symptoms suggestive of small bowel volvulus.
• Multidetector computed tomography (MDCT) angiography was employed for initial diagnosis.
• Laparotomy revealed a jejunal diverticulum, elongated mesentery with narrow insertion, and reduced mesenteric fat.

Findings:

• MDCT angiography proved effective in diagnosing small bowel volvulus.
• The patient's condition was associated with a combination of jejunal diverticulum and unique mesenteric characteristics.
• Multiple etiological factors contributing to small bowel volvulus were identified in this rare case.

Implications:

• This case underscores the diagnostic utility of MDCT angiography for small bowel volvulus.
• Understanding the interplay of anatomical factors and diverticula is crucial for managing secondary small bowel volvulus.
• Sharing treatment experiences can improve outcomes for this rare but serious condition.