Abstract
We report 3 cases of secondary volvulus of the small intestine after total gastrectomy with Roux-en-Y reconstruction. Patient 1 : A 35-year-old man was admitted to our hospital for back pain. Abdominal computed tomography (CT) showed a whirl sign and a cut-off sign of the superior mesenteric vein ; therefore, an emergency operation was performed. A major part of the small intestine was congested and twisted approximately 360° clockwise because of mesenteric torsion. Patient 2 : A 72-year-old man was admitted to our hospital for abdominal pain. Abdominal CT showed a whirl sign. Conservative treatment with a long tube was ineffective ; therefore, an emergency operation was performed. A major part of the small intestine was twisted approximately 540° clockwise because of mesenteric torsion. Patient 3 : A 66-year-old man was admitted to our hospital for abdominal pain. Abdominal CT suggested strangulated obstruction ; therefore, an emergency operation was performed. A major part of the small intestine was dilated and twisted approximately 180° clockwise around the superior mesenteric artery. No necrosis of the small intestine was observed, and torsion was released in all cases.
