Márquez-Díaz Adrián, Ramírez-Ortega Miguel Angel
Hospital General de Zona con Unidad de Medicina Familiar 23, Instituto Mexicano del Seguro Social, Chihuahua, Mexico.
Rev Med Inst Mex Seguro Soc. 2010 Mar-Apr;48(2):209-14.
Colon volvulus (CV) is the twisting or rotation of an intestinal segment over the mesenterium, which causes occlusion and vascular compromise. It is a frequent disease in individuals over 65 years-old. We report a young patient with right CV and necrosis.
A 17 year-old male with clinical findings of acute abdomen presented in the emergency room. During the surgical procedure, a right sided was found, CV with ileocecal valve and caecum ischemia and right colon necrosis with mesenteric vessels thrombosis. The case presented begun with sudden abdominal pain, with intestinal occlusion data, and widespread peritoneal rebound tenderles which suggested an intestinal occlusion. A simple abdomen Rx showed prominent right side colon distention with air levels in small bowel and a "coffee bean" image, suggestive of CVA hemicolectomy with termino-lateral ileocolic anastomosis was performed.
Right-sided CV is considered as congenital in origin. They corresponded to 21% of cases in Mexico, with an average age of presentation at 62 years. The CV represents 10% of the causes of large bowel obstruction in Mexico. This is the first case in young people reported in Mexican literature.
结肠扭转（CV）是肠段围绕肠系膜发生扭转或旋转，导致肠腔阻塞和血运障碍。它在65岁以上人群中是一种常见疾病。我们报告一例患有右半结肠扭转及坏死的年轻患者。
一名17岁男性因急腹症临床表现就诊于急诊室。手术过程中，发现为右侧结肠扭转，伴有回盲瓣和盲肠缺血以及右半结肠坏死和肠系膜血管血栓形成。该病例起病为突发腹痛，伴有肠梗阻表现，以及广泛的腹膜反跳痛，提示肠梗阻。简单的腹部X线检查显示右半结肠明显扩张，小肠内有气液平面，呈“咖啡豆”样影像，提示结肠扭转。遂行右半结肠切除术并端端-侧侧回结肠吻合术。
右侧结肠扭转被认为起源于先天性。在墨西哥，它们占病例的21%，平均发病年龄为62岁。结肠扭转占墨西哥大肠梗阻病因的10%。这是墨西哥文献中报道的首例年轻患者病例。
