A Rare Case of Primary Midgut Volvulus Necessitating Extensive Bowel Resection in an Adult

Abstract

A cause of acute intestinal obstruction in adults, midgut volvulus can be categorized into two types: primary type with no identifiable underlying cause, and secondary type that occurs in the presence of a predisposing condition such as, postoperative adhesions. Primary midgut volvulus can lead to bowel ischemia and necrosis, making an extensive bowel resection imminent. A potential consequence of bowel resection is short-bowel syndrome - a failure of digestion and absorption by the intestines, leading to malnutrition and other complications. As such, we report the diagnosis and management of primary midgut volvulus - a rare entity in adults - occurring in an adult patient.

Keywords: acute intestinal obstruction; mesenteric ischemia; midgut volvulus; short bowel syndrome.

Figure 1. Computed tomography scan of the patient showing the classic “whirlpool” sign (red arrow).

Figure 2. Approximately 250 cm of resected gangrenous small bowel.

Figure 3. The three branches of the abdominal aorta, celiac trunk, superior mesenteric artery, and inferior mesenteric artery supply the foregut, midgut, and hindgut respectively.