小腸軸捻転で発症した高齢者腸回転異常症の1例

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  • AN OLD AGE CASE OF INTESTINAL MALROTATION PRESENTING WITH SMALL BOWEL VOLVULUS

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An 87-year-old woman was seen at the hospital because of bowel obstructive symptoms. On admission mild peritoneal signs were recognized. Abdominal CT scan demonstrated small bowel loops encircling the superior mesentric artery. The patient was diagnosed as having small bowel volvulus and emergent laparotomy was carried out 3 hrs after admission. During the operation it was found that the small bowel from proximal portion of the jejunum to terminal portion of the ileum twisted clockwise by 360°. Malrotation of the intestine was recognized. The cecum was at its normal position, but the duodenojejunal portion was at the right side of the superior mesenteric artery and the Treitz ligament was not formed. Removal of the volvulus was carried out. The postoperative course was uneventful.<br> Intestinal malrotation occuring in adults is really rare and few cases are able to be diagnosed preoperatively. For the improvement of the prognosis, early diagnosis and operative treatment are necessary. In our case, successful early diagnosis based on distinctive CT findings enabled us to save the life of the patient who was as old as 87 years old.

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