Our Summary

The research paper discusses a rare case of intestinal blockage in an adult caused by a condition called small bowel volvulus. This condition, more common in children, occurs when a part of the small intestine twists around itself, causing a blockage.

In this case, a 30-year-old man with an unrelated disease, sarcoidosis, was diagnosed with small bowel volvulus. The diagnosis was made using a specialized scan and confirmed with exploratory surgery. The twisted intestine was untwisted without having to remove any part of the intestine.

However, the condition recurred after a few days, and another surgery was performed. Again, the intestine was untwisted without removing any part of it. The man was also given treatment for sarcoidosis, and he improved well enough to be sent home.

The paper concludes that early and correct diagnosis of small bowel volvulus can avoid the need for removing parts of the intestine. It mentions that many surgical procedures used to treat this condition have a high rate of complications. Therefore, the researchers recommend a conservative approach, untwisting the intestine without removing any part of it, as the best treatment option with the lowest risk of complications and death.

FAQs

  1. What is small bowel volvulus and how common is it in adults?
  2. What is the recommended treatment for small bowel volvulus in adults?
  3. How does the management of small bowel volvulus differ between adults and children?

Doctor’s Tip

A helpful tip a doctor might tell a patient about intestinal resection is to follow conservative surgical management whenever possible. In cases of small bowel volvulus, early and correct diagnosis can prevent the need for large intestinal resections. It is important to work closely with your healthcare team to explore all treatment options and choose the approach that offers the lowest risk of complications and best chance for successful recovery. Additionally, ongoing medical treatment for any underlying conditions, such as sarcoidosis, can help support overall health and reduce the risk of recurrence.

Suitable For

Patients who are typically recommended intestinal resection are those with severe cases of intestinal obstruction that cannot be managed conservatively or with less invasive procedures. In cases where there is extensive damage to the intestines, such as necrosis or perforation, intestinal resection may be necessary to prevent further complications such as sepsis. Additionally, patients with recurrent episodes of small bowel volvulus may also require intestinal resection to prevent future recurrences. However, in cases where the volvulus can be successfully managed without resection and the patient’s condition is stable, conservative surgical management may be recommended to minimize morbidity and mortality rates.

Timeline

  • Patient presents with acute abdomen and clinical data of intestinal obstruction
  • Small bowel volvulus is diagnosed by contrast abdominal tomography
  • Exploratory laparotomy is performed with devolvulation and no intestinal resection
  • Recurrent small bowel volvulus develops in the days following surgery
  • Another surgery is performed to manage the recurrent volvulus, again without intestinal resection
  • Medical treatment for sarcoidosis is started
  • Patient’s clinical progress is satisfactory and is discharged to home
  • Conservative surgical management (no intestinal resection) is recommended for small bowel volvulus to prevent complications and reduce morbidity and mortality rate.

What to Ask Your Doctor

  1. What is intestinal resection and when is it necessary for treating small bowel volvulus?
  2. What are the potential risks and complications associated with intestinal resection?
  3. Are there alternative treatments to intestinal resection for small bowel volvulus?
  4. How will intestinal resection impact my recovery and long-term health?
  5. What is the success rate of surgical management without intestinal resection for small bowel volvulus?
  6. How will my underlying condition (such as sarcoidosis) affect the treatment and outcome of small bowel volvulus?
  7. What is the post-operative care plan if intestinal resection is needed?
  8. Are there any lifestyle changes or precautions I should take after surgery to prevent recurrence of small bowel volvulus?

Reference

Authors: Santín-Rivero J, Núñez-García E, Aguirre-García M, Hagerman-Ruiz-Galindo G, de la Vega-González F, Moctezuma-Velasco CR. Journal: Cir Cir. 2015 Nov-Dec;83(6):522-6. doi: 10.1016/j.circir.2015.05.033. Epub 2015 Jul 3. PMID: 26144269