Abstract
The patient, a sixty-seven year old man, was admitted to our hospital on September 3, 1988. He had undergone total laryngectomy for laryngeal cancer ten years ago. He was proficient in esophageal speech. The day before admission he experienced severe central abdominal pain followed by abdominal distension. A scout film of the abdomen showed distended loops of small bowel with multiple fluid levels. Abdominal distension did not show any improvement in spite of the conservative therapy. Bloody stool was obeserved two days after the admission.
Laparotomy, which was performed under the tentative diagnosis of strangulated intestine, revealed small bowel volvulus of about two meters length from a point 140cm beyond the duodeno-jejunal junction. Twist of the bowel and its mesentery was 180-degree toward the counterclockwise direction. No associated anatomical abnormality was found in the intestine and its mesentery. The twisting portion of the intestine, demonstarting marked edema and discoloration, was resected, and end-to-end anastomosis was performed. He took a smooth postoperative course.
Large volume of air in the bowel and strong peristalsis resulting from frequent swallowing of air might be an etiologic factor of this disease.
