Presentation of Small Bowel Volvulus in East Africa: A Case Report

Introduction: SBV (small bowel volvulus) is a benign gastrointestinal surgical disease in which a section of the small bowel is torn along its mesenteric axis. Preoperative clinical diagnosis is problematic due to the clinical presentation’s resemblance to acute mesenteric ischaemia. It has contributed greatly to the burden in underdeveloped nations as a presenting surgical cause of small bowel obstruction. The goal of this case report was to highlight the importance of resuscitation and early surgical intervention in a typical instance of small bowel volvulus in a poor nation.

Case Description: A 35-year-old woman was taken to the hospital after three days of colicky central stomach pain. She reported a protracted time of fasting followed by a burst of food consumption. On physical examination, her abdomen was moderately distended with minimal pain. The laboratory tests came back normal, and an abdominal X-ray revealed signs that pointed to a tiny intestine obstruction. The patient was transported to the operating room for a laparotomy after resuscitation, where SBV was detected. The omental band adhesion was severed, the volvulus was untwisted, and the small bowel was found to be functional. The patient’s recuperation was uneventful after surgery.

SBV is more common in Africa, Asia, and the Middle East than in Europe and North America. Primary SBV is more common in youngsters, but secondary SBV is more common in older persons. Abdominal pain, distention, and vomiting are the most prevalent symptoms of SBV. With early detection thanks to abdominal CT scanning, the death rate from SBV has been observed to be reducing. The incidence of SBV gangrene has decreased, which has resulted in a decrease in mortality.

Because of the high mortality and diverse presentation, small bowel volvulus should be considered a possible diagnosis in a patient with stomach distress and signs of small intestinal blockage. Early surgical surgery can reduce SBV morbidity and death.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

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