A RARE CASE OF VOLVULUS CAUSED BY INTESTINAL OBSTRUCTION WITH A FOREIGN BODY.

Introduction: Small bowel volvulus(SBV) is the torsion of the small bowel and its mesentery, and it is a medical emergency. It is categorized as primary or secondary type. Primary SBV is defined as torsion of a segment of the small bowel at the mesentery basis without any evident underlying cause; secondary SBV occurs in the presence of an acquired condition, such as congenital malrotation, postoperative adhesions, and diverticular disease. Case Report: In this paper, we present the case of an 80-year-old male patient who came to the emergency department with diffuse abdominal pain, nausea, and vomiting. From the personal pathological history, we note the cholecystectomy in 2009, hypertension, and peripheral polyneuropathy. The objective examination revealed a distended abdomen, above the xipho-pubic plane, very sensitive at palpatory examination. Abdominal CT examination revealed intestinal jejunal loops depleted of semifluid content with a luminal diameter of 3 cm and only minimal aerial content, sketching 2 small hydroaeric levels; diverticulums on a small segment of the jejunum, and multiple colonic diverticulosis throughout. It was decided that the patient needed medical-surgical care. The surgical intervention began with exploratory laparotomy followed by the sectioning of the bridle that was caused by post-operatory adhesions. The adhesions contributed to the formation of SBV. Since the intestine was viable detorsion was needed. During the intervention, a compact foreign body of spherical shape was discovered in the small intestine and removed. The foreign body revealed itself after extraction as chicken bones. Discussions : The fibrous adhesions may have originated from previous surgery and/or inflammation induced by the multiple diverticulum found along the patient's bowel. The adhesion bands caused obstruction in the small bowel and promoted the unusual formation of the mass of bones that fortunately did not perforate the intestine. Clinical presentation of volvulus is usually nonspecific unless an acute small bowel obstruction occurs, which in this case was most likely caused by the foreign body. Conclusions: In summary, we presented a case of small bowel volvulus that may be categorized as the secondary type. Early surgical treatment is essential for small bowel volvulus and we should raise suspicion for small bowel volvulus when a patient displays symptoms such as upper abdominal pain, vomiting, and tenderness. [ABSTRACT FROM AUTHOR]