Grasso Emanuele, Sciolli Leander
Department of General Surgery and Traumatology, Locarno Regional Hospital, Switzerland.
Ann Ital Chir. 2011 Sep-Oct;82(5):413-6.
We present a case of spontaneus small bowel volvulus in an adult patients who presented to the emergency department. In this case we had no obvious precipitating factors.
A man of 72 years, was transferred to our hospital after being examined and diagnosed with acute pain. Over the past two years has had four episodes of sharp epigastric pain radiating to the back half with associated nausea and vomiting. He is an alcoholic and heavy smoker. His medical history, blood, urine and biochemical data were all non-cotributory. An abdominal CT angiography, we noticed a swirling mass of mesenteric and small bowel with adjacent around the superior mesenteric artery.
A case of spontaneus volvulus of the small intestine in an adult with a review of the literature is reported.
SBV is an uncommon but potentially serious cause of small bowel obstruction in Western countries, carrying an overall mortality rate of 10% to 35%. In the presence of gangrene, mortality is usually 40% or greater. Physicians should consider, in patients with obstruction of the small intestine where their pain is excessive and does not respond to treatment with narcotics analgesic the possibility of volvulus of the mesentery. If the diagnosis is suspected emergency surgical is necessary, conservation measures usually result in a higher rate of gangrene. Although no studies have identified an optimal surgical treatment, resection and primary anastomosis has been recommended in all cases.
我们报告一例成年患者自发性小肠扭转的病例，该患者被送至急诊科。在本病例中，我们未发现明显的诱发因素。
一名72岁男性，在接受检查并被诊断为急性疼痛后被转至我院。在过去两年中，他曾有过四次上腹部剧痛发作，疼痛向后背部放射，伴有恶心和呕吐。他是一名酗酒者和重度吸烟者。他的病史、血液、尿液和生化检查数据均无异常。腹部CT血管造影显示，肠系膜和小肠有一团漩涡状肿物，围绕肠系膜上动脉。
报告一例成年患者自发性小肠扭转的病例，并对相关文献进行综述。
在西方国家，小肠扭转是小肠梗阻的一种罕见但可能严重的病因，总体死亡率为10%至35%。若出现坏疽，死亡率通常在40%或更高。对于小肠梗阻且疼痛剧烈且对麻醉性镇痛药治疗无反应的患者，医生应考虑肠系膜扭转的可能性。若怀疑诊断，紧急手术是必要的，保守治疗通常会导致更高的坏疽发生率。尽管尚无研究确定最佳的手术治疗方法，但所有病例均建议行切除及一期吻合术。
