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Saturday, 29 June 2013

CASE 197: MIDGUT VOLVULUS, Dr LÊ THANH LIÊM, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 23 yo male patient came to Binh An hospital in Kien giang province with severe pain at his bossom  for  2 days, no diarrhea nor fever.  In last year he suffered some abdominal pain crisis in some times and the pain went away soon with or without medicine drugs.

In present time he cannot lie down and has to be in sitting position to reduce his pain and the pain getting prolonged.




Contrast-enhanced CT showing wrapping of the superior mesenteric vein around the SMA. 

Ultrasound detected edema of mesentery, no thickening of bowel wall and no free fluid. But the superior mesenteric artery SMA twisted itseft at  lower portion and having still flow. CT showed a case of midgut volvulus with contrast-enhanced CT showing wrapping of the superior mesenteric vein around the SMA, but with unclear cause. Plain film X-Ray revealed an intestinal obstruction. 
Surgery was done for removing twisted bowel due to an adhesive band without history of abdominal operation before. After removing the adhesive band and the twisted bowel, entire small bowel turned back in normal color.


Post-Op Diagnosis: Midgut Volvulus by adhesive band.

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