Case Report
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World J Gastroenterol. Jul 14, 2010; 16(26): 3343-3346
Published online Jul 14, 2010. doi: 10.3748/wjg.v16.i26.3343
Abdominal separation in an adult male patient with acute abdominal pain
Bao-Lin Liu, Yang Chen, Shi-Qing Liu, Xiao-Bo Zhang, Dong-Xu Cui, Xian-Wei Dai
Bao-Lin Liu, Yang Chen, Shi-Qing Liu, Xiao-Bo Zhang, Dong-Xu Cui, Xian-Wei Dai, Hepato-Pancreato-Biliary, Oncology and Organ Transplatation Division, Department of Surgery, Shengjing Hospital, China Medical University, Shenyang, 110004, Liaoning Province, China
Author contributions: Liu BL designed and revised the article; Chen Y and Liu SQ contributed to the patient management and wrote the article; Zhang XB contributed to the patient care and reference management; Cui DX and Dai XW supervised for the patient management and revised the article.
Correspondence to: Xian-Wei Dai, MD, PhD, Professor, Hepato-Pancreato-Biliary, Oncology and Organ Transplatation Division, Department of Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China. daixianwei@hotmail.com
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Received: February 2, 2010
Revised: March 18, 2010
Accepted: March 25, 2010
Published online: July 14, 2010
Abstract

We report a male patient with prolonged post-prandial abdominal distension and a sudden onset of epigastric pain initially diagnosed as acute abdomen. The patient had no history of surgery. Physical examination revealed peritonitis and abdominal computed tomography scan showed upper abdominal mesentery intorsion. The patient then underwent surgical intervention. It was found that the descending mesocolon dorsal root was connected to the ascending colon and formed a membrane encapsulating the small intestine. The membrane also formed an orifice in the ileal pars caeca, from which a 30 cm herniated ileum formed a “C”-shaped loop which was strangulated by the orifice. An abdominal separation was diagnosed after surgery. We liberated the membranous peritoneum which incarcerated the intestinal canal from the root of ileocecal junction to Treitz ligament, and reduced the small intestinal malrotation. The patient had an uneventful recovery after operation with his abdominal distention disappeared during the follow-up. Abdominal separation is a rare situation, which may be related with embryo development. Surgery is a choice of treatment for it.

Keywords: Abdominal separation; Abdominal pain; Internal hernia; Malrotation; Acute abdomen