An unusual presentation of small bowel volvulus: A case report

Abstract

Introduction: Small bowel volvulus (SBV) is a surgical emergency that requires prompt diagnosis and treatment. Although sudden onset acute abdominal pain is the most common presenting symptom, the clinical presentation of SBV can be misleading. Early diagnosis and treatment are therefore crucial for a good outcome. Case Report: A 49-year-old woman presented with a 5-hour history of nausea as her only symptom. Six hours after admission, she developed multiple episodes of vomiting, but without abdominal pain. An urgent CT of the abdomen revealed a pathognomonic “whirl” pattern highly suggestive of SBV, and emergency laparoscopy revealed ileal volvulus without any identifiable pathoetiological factors. She underwent simple devolvulation and made a rapid recovery without recurrence at 12 months. Conclusion: This case highlights that the preoperative clinical diagnosis of small bowel volvulus can be challenging, emphasizing the importance of preoperative imaging and maintaining a high index of suspicion to avoid missing this important diagnosis. A laparoscopic approach can be used successfully to treat SBV.