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Primary small intestinal volvulus after laparoscopic rectopexy for rectal prolapse.

Michihiro Koizumi1, Takeshi Yamada1, Seiichi Shinji1

  • 1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.

Asian Journal of Endoscopic Surgery
|February 2, 2018
PubMed
Summary

Primary small intestinal volvulus, a rare complication, occurred after laparoscopic rectopexy. This case highlights the potential for early postoperative small bowel obstruction following this procedure.

Keywords:
Intestinal volvuluspostoperative complicationsrectal prolapse

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Primary small intestinal volvulus is defined as intestinal torsion without congenital malrotation, bands, or adhesions.
  • Early postoperative small intestinal volvulus is an uncommon complication.

Observation:

  • A 40-year-old woman underwent laparoscopic rectopexy for rectal prolapse.
  • Postoperatively, she experienced intolerance to oral intake and developed abdominal pain.
  • Contrast-enhanced CT identified small intestinal mesenteric torsion.

Findings:

  • Emergent laparotomy confirmed primary small intestinal volvulus without malformations or adhesions.
  • Strangulated intestine required resection and reconstruction.
  • The patient recovered fully after the second surgery.

Implications:

  • This is the first reported case of primary small intestinal volvulus following rectopexy for rectal prolapse.
  • Primary small intestinal volvulus should be considered a potential postoperative complication after laparoscopic procedures.