Three cases of primary voluvulus of the small intestine in adults

Abstract

Patient 1 : An 87-year-old man was admitted for abdominal pain. Abdominal computed tomography (CT) showed torsion of the small intestine and emergency operation was performed. The small intestine was dilated and twisted about 360° clockwise around the superior mesenteric artery. Patient 2 : A 74-year-old woman was admitted for nausea, diarrhea and anorexia. Abdominal CT showed torsion of the small intestine and emergency operation was performed. Patient 3 : A 28-year-old woman was admitted for lower abdominal pain and diarrhea after excessive consumption of nuts. Abdominal CT showed a positive whirl sign and emergency operation was performed. No necrosis of the small intestine was present, therefore, reduction of the torsion was performed in each of the cases. Excessive consumption of nuts was considered to be the trigger of the torsion in patient 3. We wish to emphasire that attention must be paid to non specific symptoms, such as abdominal pain, vomiting and diarrhea. Early diagnosis can be made from the characteristic abdominal CT findings and a good prognosis can be expected by early treatment without resection of the small intestine.