Acuña PR, Madera M, Ortega I, Sosa C

Language: Spanish
References: 15
Page: 116-119
PDF size: 51.92 Kb.

ABSTRACT

Objective: To describe the case of a patient with an intestinal obstruction secondary to a volvulus of the small intestine due to a Meckel’s diveritculum and misrotation of the colon.
Setting: Second level health care hospital.
Description of the case: A 22 years old man, without important antecedents, who presented colic-type abdominal pain, diffuse, intermittent, progressive, accompanied by nausea and vomiting of gastro-biliary content in multiple occasions and unable to canalize gases. Physical exploration revealed: no fever, severe dehydration, pale, no cardiopulmonary alterations, flat abdomen painful to mid and profound palpation of the lower hemiabdomen, without data of peritoneal irritation, diminished peristalsis. Thorax X rays revealed no subphrenic free air, plain abdominal X rays showed small air levels in the small intestine at the mesogastrium and left iliac fosse, no gas in the colon, and no important dilation of the small intestine. The exploratory laparotomy revealed intestinal obstruction secondary to a volvulus of the small intestine due to a Meckel’s diverticulum joined to the umbilical scar by a band and misrotation of the colon, with the Treitz ligament to the right, the cecum and ascending colon were mobile with Ladd bands.
Conclusion: We describe a case in which two congenital causes of intestinal obstruction coincide. Early intervention is fundamental to avoid necrosis of the whole mid-intestine.

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