Sabzi Feridon, Rozbahani Mohammad, Heidar Aghighe, Faraji Reza
Kermanshah Cardiovascular Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Caspian J Intern Med. 2021;12(Suppl 2):S417-S420. doi: 10.22088/cjim.12.0.417.
Volvulus of colon is a very rare phenomenon in post cardiac surgery course, and their predicting factor in most patients is unknown. Between colonic volvulus, splenic flexure is the rarest site for torsion in general population. The main symptoms are vague abdominal pain, vomiting and distension. The primary diagnostic images include plain chest x-ray, CT scan and colonoscopy.
We report the case of a 57-year -old opium male addict, who was. Admitted for abdominal pain, nausea, and vomiting five days after off-pump coronary artery bypass surgery (OPCAB). An abdominal x-ray reported a colonic volvulus. Exploratory laparotomy showed acute abdomen resulting from a gangrene of long segment of splenic flexure caused by volvulus.
Gastrointestinal complication such as volvulus is an exceedingly rare complication of OPCAB, despite the absence of anatomic abnormalities only complete colonic malrotation as the result of mega colon and constipation, the main pathogenetic causes. This patient was unique because of careful literature search revealed that this case was the first reported volvulus that has been described so far.
结肠扭转在心脏手术后病程中是一种非常罕见的现象，大多数患者的预测因素尚不清楚。在结肠扭转中，脾曲是一般人群中最罕见的扭转部位。主要症状为腹部隐痛、呕吐和腹胀。主要诊断影像包括胸部平片、CT扫描和结肠镜检查。
我们报告一例57岁男性阿片类药物成瘾者，在非体外循环冠状动脉搭桥手术（OPCAB）后5天因腹痛、恶心和呕吐入院。腹部X线检查报告为结肠扭转。剖腹探查显示为因扭转导致脾曲长段坏疽引起的急腹症。
尽管没有解剖异常，仅因巨结肠和便秘这两个主要致病原因导致完全性结肠旋转不良，但扭转等胃肠道并发症是OPCAB极为罕见的并发症。该患者很独特，因为仔细查阅文献发现该病例是迄今为止首次报道的结肠扭转病例。
