Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2015; 21(36): 10480-10484
Published online Sep 28, 2015. doi: 10.3748/wjg.v21.i36.10480
Small bowel volvulus with jejunal diverticulum: Primary or secondary?
Xiao-Fei Shen, Wen-Xian Guan, Ke Cao, Hao Wang, Jun-Feng Du
Xiao-Fei Shen, Wen-Xian Guan, Ke Cao, Hao Wang, Department of General Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
Jun-Feng Du, Department of General Surgery, General Hospital of Beijing Military Command, Beijing 100700, China
Author contributions: Shen XF and Guan WX contributed equally to this work as co-first authors; Shen XF wrote the manuscript and retrieved the relevant literature; Cao K performed the surgery and managed the patient; Wang H helped retrieved the literature; Du JF revised the manuscript and guided the study; and Guan WX performed the surgery, wrote the manuscript and supervised the study.
Supported by National Natural Science Foundation of China, No. 81372364 and No. 81000189; and General Financial Grant from the China Postdoctoral Science Foundation, No. 2014M552695.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee for Medical Research of the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Jun-Feng Du, Department of General Surgery, General Hospital of Beijing Military Command, No. 5 Nan Men Cang, Beijing 100700, China. dujf66@126.com
Telephone: +86-10-84008099 Fax: +86-10-66721188
Received: January 20, 2015
Peer-review started: January 21, 2015
First decision: April 13, 2015
Revised: April 22, 2015
Accepted: July 3, 2015
Article in press: July 3, 2015
Published online: September 28, 2015
Processing time: 250 Days and 12.3 Hours
Abstract

Small bowel volvulus, which is torsion of the small bowel and its mesentery, is a medical emergency, and is categorized as primary or secondary type. Primary type often occurs without any apparent intrinsic anatomical anomalies, while the secondary type is common clinically and could be caused by numerous factors including postoperative adhesions, intestinal diverticulum, and/or tumors. Here, we report a rare case of a 60-year-old man diagnosed with small bowel volvulus using multidetector computed tomography (MDCT) angiography. Further discovery by laparotomy showed one jejunal diverticulum, longer corresponding mesentery with a narrower insertion, and a lack of mesenteric fat. This case report includes several etiological factors of small bowel volvulus, and we discuss the possible cause of small bowel volvulus in this patient. We also highlight the importance of MDCT angiography in the diagnosis of volvulus and share our experience in treating this disease.

Keywords: Small bowel volvulus; Jejunal diverticulosis; Laparotomy; Laparoscopic cholecystectomy; Fibrous adhesions

Core tip: We present a case report of a patient diagnosed with small bowel volvulus using multidetector computed tomography angiography. Further discovery by laparotomy showed one jejunal diverticulum, longer corresponding mesentery with a narrower insertion, and a lack of mesenteric fat. We discussed the possible cause of small bowel volvulus, and demonstrated the surgical skills in treating chronic small bowel volvulus.