Abstract
A 74-year-old woman visited our hospital because of sudden abdominal pain and nausea. Abdominal computed tomography showed a whirl sign and dilatation of part of the small intestine. Emergency surgery was performed for presumptive strangulated ileus of the small intestine. Part of the small intestine was rotated approximately 360° counterclockwise because of mesenteric torsion and the upper jejunal segment (from 20 to 150 cm distal to the ligament of Treitz) had many diverticula. The volvulus was corrected with clockwise rotation to the free position, without performing bowel resection. However, the patient had recurrence of bowel obstruction. Contrast medium did not pass distally toward the anal side. Surgery was performed because of severe stenosis around a diverticulum. Segmental resection of jejunum with diverticula was performed. Endoscopic examination revealed ulcers around a diverticulum, and the pathological diagnosis was diverticulitis. Mechanical obstruction caused by diverticula was thought to lead to bowel obstruction.
