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J Korean Soc Emerg Med > Volume 13(3); 2002 > Article
Journal of The Korean Society of Emergency Medicine 2002;13(3): 373-376.
Small Bowel Volvulus in Adults: A case report
Ji Ho Ryu, Hyuk Jun Yang, Gun Lee, Yong Su Lim, Jae Kwang Kim, Eell Ryoo, Jong Whan Shin, Sang Woo Oh, Wook Jin
1Department of Emergency Medicine, Ghil Medical Center, Gachon Medical School, Incheon, Korea. kjk@ghil.com
2Department of Diagnostic Radiology, Ghil Medical Center, Gachon Medical School, Incheon, Korea.
ABSTRACT
Small bowel volvulus in adults is very rare and occasionally occurs due to congenital midgut malrotation. The most common cause of small bowel volvulus is adhesions (74%), and other causes are Crohn's disease (7%), neoplasia (5%), hernia (2%), radiation (1%), and miscellaneous (11%). Presenting symptoms may be acute or present periodically during a longer period of time with a condition that is intermittent or recurrent because of spontaneous detorsion of the volvulus. Diagnostic imaging studies are plain abdominal film, ultrasonography, abdominal CT, and angiography. Abdominal CT is the most accurate. The most frequent CT finding is "Whirlpool sign." Other findings are bowel-loop dilatation, bowel-wall thickening, beak signs, mesenteric alterations, and extraluminal fluid. The mortality rate associated with small bowel volvulus in adults is 10~67%. We report a case of small bowel volvulus in adults.
Key words: Small bowel volvulus, Whirlpool sign
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