Small bowel volvulus with no malrotation after laparoscopic appendicectomy: Case report and literature review

https://doi.org/10.1016/j.ijscr.2014.10.091Get rights and content
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Highlights

  • Small bowel volvulus is a rare complication of laparoscopic surgery.

  • Prompt diagnosis and surgical treatment are essential to avoid complications.

  • Predisposing factors could be related to operative technique and anaesthesia.

Abstract

INTRODUCTION

Small bowel volvulus, as a complication of laparoscopic surgery, is a rarely reported clinical entity. We present a case of a young female who developed small intestinal volvulus after laparoscopic appendicectomy. She had this complication in the absence of malrotation or other previous abdominal operations.

PRESENTATION OF CASE

A 17-year-old woman presented with acute appendicitis. After an uneventful laparoscopic appendicectomy, she developed acute small intestinal obstruction on the second post-operative day. A prompt laparotomy showed small bowel volvulus, which was reduced, with no evidence of malrotation. She had an uneventful recovery and was discharged within 3 days of the second operation, in a stable condition.

DISCUSSION

This article presents a review of the literature of this rare cause of small intestinal obstruction after laparoscopic surgery, stressing on the importance of early diagnosis and treatment. A discussion of the potential factors predisposing to this entity is presented, emphasising the need of a higher-evidence study as to its aetiology and prevalence.

CONCLUSION

Small bowel volvulus is a rare complication of laparoscopic surgery, but its early diagnosis and prompt treatment is essential to avoid morbid outcomes. Surgery is the therapeutic mainstay.

Keywords

Small bowel volvulus
Midgut volvulus
Small bowel obstruction
Laparoscopy
Appendicectomy
Complication

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