A case of total volvulus with ischemia of the whole small-bowel on incomplete common mesentery

Abstract

Total volvulus of the small-bowel is a serious and rapid life-threatening complication of incomplete common mesentery. We are reporting on a case with ischemia of the small-bowel. Our aim is to describe the therapeutic approach and make a review of the literature. It concerned a newborn baby of 8 days who was hospitalized for an acute intestinal occlusion. The abdominal echography had enabled to diagnose a case of volvulus of the small-bowel on intestinal malrotation. Our therapeutic attitude consisted in avoiding right away large resections of doubtful areas with the hope that some of them would tum back to their initial colour with time. After the emergency laparotomy, there was a « second look » 24 hours later and a third laparotomy 72 hours after the « second look ». Only really necrotic areas were cut off. Our patient died ten days after his ad mission in a state of undernutrition and septic shock.