A CASE OF MESENTERIUM COMMUNE PRESENTED WITH VOLVULUS OF THE SIGMOID COLON

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  • Ｓ状結腸の軸捻転を呈した総腸間膜症の１例

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Abstract

A case of mesenterium commune presented with volvulus of the sigmoid colon is reported.<br> A 38-year-old man complaining of abdominal pain showed dilatation of the intestine with air-fluid level formation on an abdominal plain x-ray film. Barium enema study demonstrated bird beak's sign at a portion where was compatible with the sigmoid colon. We gave up conservative therapy because there was a risk that ischemic change might occur, and performed an emergency operation. It disclosed a condition of severe mesenterium commue, in which incomplete fixation had extended from the duodenum to descending colon, the sigmoid colon was twisted, and the transverse colon was impacted in the Winslow's foramen, showing a complicated run of the intestines. Since the volvuls was able to be reduced manually due to absence of ischemia, no intestinal resection was needed and part of the mesentery was fixed to the retroperitoneum.<br> Mesenterium commone associated with volvulus of the sigmoid colon is so rare that only 11 cases, including our case, have been reported in Japan.

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