A Rare Presentation of Adult Volvulus Successfully Managed by Laparoscopy: A Case Report

Nori, Wassan; Abdul Ghani Zghair, Muna; Abdulkareem Hamdi, Emad; Younis Khalid, Aula; Mohammed Khadhem, Ammar; Cosmin Pantazi, Alexandru

doi:10.32894/kjms.2024.151198.1110

A Rare Presentation of Adult Volvulus Successfully Managed by Laparoscopy: A Case Report

Document Type : Case Report

Authors

Wassan Nori ¹

Muna Abdul Ghani Zghair ²

Emad Abdulkareem Hamdi ³

Aula Younis Khalid ⁴

Ammar Mohammed Khadhem ⁵

Alexandru Cosmin Pantazi ⁶

¹ Department of Obstetrics and Gynecology, Faculty of Medicine, Mustansiriyah University, Baghdad, Iraq

² Department of Radiology, Faculty of Medicine, Mustansiriyah University, Baghdad, Iraq.

³ Department of Radiology, Al Yarmouk Teaching Hospital, Baghdad, Iraq.

⁴ Department of Radiology, Al Yarmouk Teaching Hospital, Baghdad, Iraq

⁵ Department of Surgery, Al Yarmouk Teaching Hospital, Baghdad, Iraq

⁶ Department of Pediatrics, Faculty of Medicine, “Ovidius” University, 900470 Constanta, Romania

https://doi.org/10.32894/kjms.2024.151198.1110

Abstract

Mid-gut volvulus (MGV) frequently occurs in infancy and childhood and is rarely seen in adults. Here, we present a 23-year-old male who presented with abdominal pain and vomiting for one-week duration.
The patient gave a long history of similar attacks in the past since the age of 16 years old, at a rate of 2-3/ attacks per year, which become more frequent in the last year. A laboratory workup was carried out, and an imaging study demonstrated a twisting of bowel loops around mesenteric vessels on ultrasound and intravenous-enhanced contrast computed tomography (CT scan). Whirlpool sign of midgut volvulus was seen on contrast CT scan. The patient underwent laparoscopic Ladd’s
procedure, where the diagnosis was confirmed, bands were resolved, and the bowel blood supply was restored. The surgery and postoperative period were uneventful. The patient became pain-free and was discharged home on the fourth postoperative day. To improve patient outcomes, physicians should practice a high suspicion index to confirm
MGV in adult cases.

Keywords

Midgut volvulus

Ladd’s procedure

Computed tomography

Whirlpool sign

laparoscopic

Subjects