Laparoscopic Surgery for Volvurous of the Duplication Bowel—Report of a Case—

Abstract

A 35-year-old man presented to our emergency clinic with abdominal pain persisting from the previous day. When he was first seen, there was tenderness from the right lower quadrant to the midline of the abdomen. A blood analysis revealed increased inflammatory response. An abdominal CT scan showed a cystic lesion adjacent to the intrapelvic small intestine and a swollen appendix. Suspecting that inflammation or abscess formation might occur due to duplication bowel, Meckel's diverticulum, and acute appendicitis, we performed emergency laparoscopic surgery. Laparoscopic surgery was started with three-ports method that revealed an intestine-like structure continuing to the ileum and sharing the mesentery. It was determined to be a duplication bowel based on intraoperative findings. It had twisted by 360 degrees at the base and the volvulus of the duplication bowel was reduced in the celom. A small laparotomy was made at the navel, from where an ileum involving the duplication bowel was taken out, and small bowel resection including the normal intestine was performed. Histopathology revealed that the cystic wall had mucosa, muscularis mucosae, proper muscle layer, and subserosal layer ; and it also had the common mesentery with the ileum. Accordingly, we diagnosed the case as duplication bowel. Here we report a case of volvulus of duplication bowel performed laparoscopic surgery.