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

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.