Abstract
A 14-year-old boy was admitted for abdominal pain. He had no history of laparotomy. Plain X-ray of the abdomen showed a dilated small intestine, and abdominal computed tomography (CT) showed a whirl shaped mass involving the small bowel and mesentery around the superior mesenteric artery. The patient was diagnosed as having volvulus of the small intestine and underwent emergency surgery. The small intestine was found to be twisted and rotated about 270°C clockwise by mesenteric torsion. Because of the absence of malrotation and other predisposing anatomical abnormalities, we diagnosed primary volvulus of the small intestine. Necrosis of the small bowel was not present, so only reduction of the torsion was performed. The patient's course was favorable. Acute abdomen in childhood presents a diagnostic challenge, especially an intestinal obstruction in the absence of a history of laparotomy. An abdominal CT scan provides useful information for diagnosing volvulus of the small intestine.
