A Case of Primary Small Intestinal Volvulus with Challenging Preoperative Diagnosis and Intraoperative Management

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Key Points

To discuss a rare case of primary small intestinal volvulus with diagnostic and procedural challenges during surgery.
Analyzed a case involving a 98-year-old female presenting with abdominal pain.
Utilized contrast CT to identify the whirl sign and planned surgery under the assumption of secondary volvulus.
Performed surgery focusing on detorsion and securing the mobile cecum without complications.
Initial diagnosis of secondary volvulus was incorrect as primary small intestinal volvulus was established postoperatively.
Successful surgery involved detorsion and mesenteric fixation with no postoperative complications.
Literature suggests that cases of recurrence only involved detorsion, highlighting the need for mesentery fixation.

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Case reveals surgical management challenges in a 98-year-old with small intestinal volvulus, indicating diagnosis improvements.

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Tsubokawa et al. (2026) studied this question.

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