A case of small bowel volvulus which is thought to be caused by jejunal diverticulum in the eldery

Abstract

Small bowel volvulus is a comparatively rare entity. We report a case of small bowel volvulus which was thought to be caused by jejunal diverticulum. A 90-year-old woman was admitted to our hospital complaining of gradually increasing abdominal pain. Abdominal CT showed the whirl sign which was peculiar to small bowel volvulus. We performed an emergency operation and found the small intestine was twisted counterclockwise 720 degrees around the superior mesenteric artery. Since there was no ischemic change of the small intestine, we only reduced the axis rotation. Then we found the jejunal diverticulum at 30 cm distal from the Treitz ligament. The diverticulum was thought to be the cause of axis rotation because of its location. The diverticulum was resected and closed primarily. We should consider small bowel volvulus in making diagnosis of small bowel obstructions. Jejunal diverticulum must be resected to prevent recurrence of small bowel volvulus.