Primary Volvulus of the Small Intestine Exhibiting Chylous Ascites: A Case Report

Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi
Tamuro HayamaTaro Yamada

Abstract

Primary volvulus of the small intestine associated with chylous ascites is very rare, with only four reported cases. In this paper, we report a new case of primary volvulus associated with chylous ascites. The patient was a 70-year-old man. After experiencing bloating and abdominal pain for several hours, he called an ambulance and underwent an emergency examination at our hospital. Abdominal distension, pressure pain, and rebound tenderness were observed throughout his entire abdomen. The patient had a history of hypertension for which he was receiving oral treatment. Abdominal contrast-enhanced computed tomography (CT) revealed an edematous change in the intestinal membrane and volvulus of the small intestine. As findings suggestive of ischemia were observed in part of the intestines, emergency surgery was performed on the day of admission. Open surgery revealed approximately 500 mL of chylous ascites in the abdominal cavity. The small intestine had twisted 180° in a counter-clockwise direction at the root of the superior mesenteric artery, and the mesentery appeared milky white with edematous changes extending 75 to 240 cm from the ligament of Treitz. There was no evidence of intestinal necrosis; therefore intestinal resecti...Continue Reading

References

Mar 1, 1979·Acta paediatrica Scandinavica·J Hertel, P V Pedersen
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Feb 1, 1969·Annals of Surgery·K Vaez-ZadehM Nowrooz-Zadeh
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Aug 24, 2012·BMJ Case Reports·Steven PengellyMelanie Feldman
Apr 30, 2013·Singapore Medical Journal·Ye Xin KohAlexander Yaw Fui Chung

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