Olgu Sunumu
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GENÇ ERİŞKİN HASTADA SEKONDER MİDGUT VOLVULUS: OLGU SUNUMU

Yıl 2016, , 90 - 93, 31.08.2016
https://doi.org/10.24938/kutfd.252685

Öz



 


Midgut
volvulus, ince barsak mezenter kökünün süperior mezenterik arter etrafında
rotasyonu sonucu oluşan nadir görülen bir malrotasyondur. İnfantlarda sık, erişkinlerde
ise nadir olarak görülmektedir. Ondokuz yaşında erkek hasta altı saat önce
başlayan şiddetli santral karın ağrısı şikâyeti ile acil servise başvurdu. Özgeçmişinden
yaklaşık iki ay önce bıçakla yaralanma sonrası eksploratif laparotomi
yapıldığı öğrenildi. Fizik muayanede batında yaygın hassasiyet ve defans
mevcut iken; laboratuar testlerinde ise beyaz küre sayısının 12 bin olması
dışında anormal bir değere rastlanmadı. Çekilen akciğer grafisinde solda
diafragma altında şüpheli serbest hava görüntüsü izlendi.
Batın ultrasonografisinde herhangi
bir patoloji izlenmeyen hastaya, intravenöz kontrast madde verilerek tüm
batın bilgisayarlı tomografi çekildi ve pankreas inferior kesimden başlayıp
iliak bifurkasyo düzeyine kadar devam eden saat yönünde yaklaşık 300
derecelik rotasyon yapan mezenterik volvulus ile uyumlu görüntü saptandı.
Genel cerrahi ile konsülte edilen hasta opere edilerek rotasyone mezenter dokusu
detorsiyone edildi. Operasyon sonrası 3. günde hasta şifa ile taburcu edildi.


Sonuç
olarak, acil servise ani başlangıçlı karın ağrısı ve intestinal obstrüksiyon
bulguları ile başvuran; özgeçmişinde geçirilmiş abdominal cerrahi öyküsü olan
hastalarda midgut volvulustan şüphelenilmelidir. Bu hastalarda erken tanı ve
hızlı cerrahi müdahale, prognozu iyileştirici anahtar faktörlerdir.


Kaynakça

  • Torres AM, Ziegler MM. Malrotation of the intestine. World J Surg. 1993; 17: 326-31.
  • White RR, Jacobs DO. Volvulus of the stomach and small bowel. In Charles Yeo et al, eds. Shackelford’s Surgery of the alimentary tract. 6th ed. Philadelphia. Elsevier Saunders. 2007; 1: 1035-7.
  • Iwuagwu O, Deans GT. Small bowel volvulus: A review. J R CollSurg Edinb. 1999; 44: 150-5.
  • Welch GH, Anderson JR. Volvulus of the small intestine in adults. World J Surg. 1986; 10: 496-500.
  • Vaez-Zadeh K, Dutz W, Nowrooz-Zadeh M. Volvulus of the small intestine in adults: A study of predisposing factors. Ann Surg. 1969; 169: 265-71
  • Ruiz-Tovar J, Morales V, Sanjuanbenito A, Lobo E, Martinez- Molina E. Volvulus of the small bowel in adults. Am Surg. 2009; 75: 1179-82.
  • Catalano OA, Bencivenga A, Abbate M, Tomei E, Napolitano M, Vanzulli A. Internal hernia with volvulus and intussusception: Case report. Abdom Imaging. 2004; 29: 164-5.
  • Bissen L, Brasseur P, Sukkarich F, Takieddine M, Frecourt N. Jejunal lipomatosis with intussusception and volvulus. A case report. J Radiol. 2004; 85: 128
  • Qayyum A, Cowling MG, Adam EJ. Small bowel volvulus related to a calcified mesenteric lymph node. Clin Radiol. 2000; 55: 483-5.
  • Roggo A, Ottinger LW. Acute small bowel volvulus in adults. A sporadic form of strangulation intestinal obstruction. Ann Surg. 1992; 216: 135-41.
  • Sheen AJ, Drake I, George PP. A small bowel volvulus caused by a mesenteric lipoma: Report of a case. Surg Today. 2003; 33: 617-9.
  • Jang JH, Lee SL, Ku YM, An CH, Chang ED. Small bowel vovlulus induced by mesenteric lymphangioma in an adult: a case report. Korean J Radiol. 2009; 10: 319-22.
  • Wax JR, Christie TL. Complete small bowel volvulus complicating the second trimester. Obstet Gynecol. 1993; 82: 689–91.
  • Furukawa A, Yamasaki M, Furuichi K, et al. Helical CT in the diagnosis of small bowel obstruction. Radiographics. 2001; 21: 341-55.
  • Duran C, Ozturk E, Uraz S, Kocakusak A, Mutlu H, Killi R. Midgut volvulus: value of multidetector computed tomography in diagnosis. Turk J Gastroenterol. 2008; 19: 189-92.

Young Adult Patient with Secondary Midgut Volvulus: A Case Report

Yıl 2016, , 90 - 93, 31.08.2016
https://doi.org/10.24938/kutfd.252685

Öz

Midgut
volvulus is a rare malrotation caused by a rotation of the small intestine
mesentery root around the superios mesenteric artery. It is seen mostly in
infants and rarely in adults. In this case report we experienced aa 19-year old
man who had central abdominal pain for 6 hours. He had a history of explorative
laparatomy because of stabbing injury about two months ago. Physical examination
showed common defence and tenderness.

The
laboratory tests were in normal range except increased white blood cells which
was 12,000. Chest radiography showed suspected abnormal presence of air in the
left diaphragm. Since the abdominal ultrasonography was normal, the patient
went through the abdominal computed tomography which showed mesenteric volvulus
of 300 degree abnormal rotation between inferior pancreas and iliac
bifurcation. The patient was taken to the operation and malrotated mesentery
was detortioned after the evaluation of general surgery department, The patient
was externed three days after the operation.





As a result; midgut
volvulus should be considered in patients with acute abdominal pain and intestinal obstruction who had a history of abdominal
surgery. Early diagnosis and surgical intervention are key factors for good
prognosis in those patients.

Kaynakça

  • Torres AM, Ziegler MM. Malrotation of the intestine. World J Surg. 1993; 17: 326-31.
  • White RR, Jacobs DO. Volvulus of the stomach and small bowel. In Charles Yeo et al, eds. Shackelford’s Surgery of the alimentary tract. 6th ed. Philadelphia. Elsevier Saunders. 2007; 1: 1035-7.
  • Iwuagwu O, Deans GT. Small bowel volvulus: A review. J R CollSurg Edinb. 1999; 44: 150-5.
  • Welch GH, Anderson JR. Volvulus of the small intestine in adults. World J Surg. 1986; 10: 496-500.
  • Vaez-Zadeh K, Dutz W, Nowrooz-Zadeh M. Volvulus of the small intestine in adults: A study of predisposing factors. Ann Surg. 1969; 169: 265-71
  • Ruiz-Tovar J, Morales V, Sanjuanbenito A, Lobo E, Martinez- Molina E. Volvulus of the small bowel in adults. Am Surg. 2009; 75: 1179-82.
  • Catalano OA, Bencivenga A, Abbate M, Tomei E, Napolitano M, Vanzulli A. Internal hernia with volvulus and intussusception: Case report. Abdom Imaging. 2004; 29: 164-5.
  • Bissen L, Brasseur P, Sukkarich F, Takieddine M, Frecourt N. Jejunal lipomatosis with intussusception and volvulus. A case report. J Radiol. 2004; 85: 128
  • Qayyum A, Cowling MG, Adam EJ. Small bowel volvulus related to a calcified mesenteric lymph node. Clin Radiol. 2000; 55: 483-5.
  • Roggo A, Ottinger LW. Acute small bowel volvulus in adults. A sporadic form of strangulation intestinal obstruction. Ann Surg. 1992; 216: 135-41.
  • Sheen AJ, Drake I, George PP. A small bowel volvulus caused by a mesenteric lipoma: Report of a case. Surg Today. 2003; 33: 617-9.
  • Jang JH, Lee SL, Ku YM, An CH, Chang ED. Small bowel vovlulus induced by mesenteric lymphangioma in an adult: a case report. Korean J Radiol. 2009; 10: 319-22.
  • Wax JR, Christie TL. Complete small bowel volvulus complicating the second trimester. Obstet Gynecol. 1993; 82: 689–91.
  • Furukawa A, Yamasaki M, Furuichi K, et al. Helical CT in the diagnosis of small bowel obstruction. Radiographics. 2001; 21: 341-55.
  • Duran C, Ozturk E, Uraz S, Kocakusak A, Mutlu H, Killi R. Midgut volvulus: value of multidetector computed tomography in diagnosis. Turk J Gastroenterol. 2008; 19: 189-92.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Derleme
Yazarlar

Erdal Demirtaş Bu kişi benim

Bülent Demir Bu kişi benim

Soykan Topçu Bu kişi benim

Esin Demirtaş Bu kişi benim

Yusuf Kenan Tekin Bu kişi benim

Yayımlanma Tarihi 31 Ağustos 2016
Gönderilme Tarihi 16 Ağustos 2016
Yayımlandığı Sayı Yıl 2016

Kaynak Göster

APA Demirtaş, E., Demir, B., Topçu, S., Demirtaş, E., vd. (2016). Young Adult Patient with Secondary Midgut Volvulus: A Case Report. The Journal of Kırıkkale University Faculty of Medicine, 18(2), 90-93. https://doi.org/10.24938/kutfd.252685
AMA Demirtaş E, Demir B, Topçu S, Demirtaş E, Tekin YK. Young Adult Patient with Secondary Midgut Volvulus: A Case Report. Kırıkkale Üni Tıp Derg. Ağustos 2016;18(2):90-93. doi:10.24938/kutfd.252685
Chicago Demirtaş, Erdal, Bülent Demir, Soykan Topçu, Esin Demirtaş, ve Yusuf Kenan Tekin. “Young Adult Patient With Secondary Midgut Volvulus: A Case Report”. The Journal of Kırıkkale University Faculty of Medicine 18, sy. 2 (Ağustos 2016): 90-93. https://doi.org/10.24938/kutfd.252685.
EndNote Demirtaş E, Demir B, Topçu S, Demirtaş E, Tekin YK (01 Ağustos 2016) Young Adult Patient with Secondary Midgut Volvulus: A Case Report. The Journal of Kırıkkale University Faculty of Medicine 18 2 90–93.
IEEE E. Demirtaş, B. Demir, S. Topçu, E. Demirtaş, ve Y. K. Tekin, “Young Adult Patient with Secondary Midgut Volvulus: A Case Report”, Kırıkkale Üni Tıp Derg, c. 18, sy. 2, ss. 90–93, 2016, doi: 10.24938/kutfd.252685.
ISNAD Demirtaş, Erdal vd. “Young Adult Patient With Secondary Midgut Volvulus: A Case Report”. The Journal of Kırıkkale University Faculty of Medicine 18/2 (Ağustos 2016), 90-93. https://doi.org/10.24938/kutfd.252685.
JAMA Demirtaş E, Demir B, Topçu S, Demirtaş E, Tekin YK. Young Adult Patient with Secondary Midgut Volvulus: A Case Report. Kırıkkale Üni Tıp Derg. 2016;18:90–93.
MLA Demirtaş, Erdal vd. “Young Adult Patient With Secondary Midgut Volvulus: A Case Report”. The Journal of Kırıkkale University Faculty of Medicine, c. 18, sy. 2, 2016, ss. 90-93, doi:10.24938/kutfd.252685.
Vancouver Demirtaş E, Demir B, Topçu S, Demirtaş E, Tekin YK. Young Adult Patient with Secondary Midgut Volvulus: A Case Report. Kırıkkale Üni Tıp Derg. 2016;18(2):90-3.

Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.