Abstract
The patient was a 22-year-old man who visited the emergency department complaining of sudden abdominal pain and vomiting three hours after meals. Abdominal CT revealed a “whirl-like sign”. We diagnosed the case as volvulus of the small intestine. At laparotomy, a moderate amount of chylous ascites was observed in the peritoneal cavity. The small intestine had rotated 270-360°counterclockwise around the superior mesenteric artery. The mesentery of the small intestine from the ligament of Treitz to 90-660 cm was presented with chylous edema. The volvulus was rotated back to the correct position without bowel resection. The patient's post-operative course was uneventful. One month after discharge, abdominal CT and abdominal ultrasonography showed improvement of the mesenteric edema. Volvulus of the small intestine in adults with chylous ascites and chylous mesenteric edema is rare and only four cases have been reported.
