Segmental Volvulus Case Study

Segmental Intestinal volvulus without underlying caused called Primary Segmental Volvulus, It is very rare entity few cases were reported in the literature. We report a rare case of segmental ileal volvulus associated with acute appendicitis.
Case Presentation:
A 3 years old boy complains of diarrhea associated with vomiting, central abdominal pain and decreased activity for 2 days duration referred to paediatric surgery as a case of acute appendicitis, U/S abdomen shows sign of of acute appendicitis with Ileoileal Target sign. Laparotomy was done which shows segmental ileal volvulus without malrotation associated with Inflamed Appendix and fecolith at the tip, appendectomy plus intestinal resection and anastomosis was done.
Discussion:
Primary

It is common in neonates and children due to malrotation. In the literature, there are other causes such as congenital bands, post-operative adhesions, duplication cyst, meconium plug, Meckel's diverticulum, internal herniation, and ventriculoperitoneal shunt (1-4). Intestinal volvulus without underlying causes called primary segmental volvulus ( PSV ). It is a rare condition few cases were reported in the literature. We report a case diagnosed as acute appendicitis clinically and radiologically, intraoperatively shows a primary segmental volvulus of the ileum associated with Inflamed Appendix and fecolith at the

then segmental intestinal volvulus ( Figure 3 ) 45 cm from the ileocecal valve with whitish serosa and necrotic tissue. Inspection of the whole digestive system from sigmoid to the stomach was done and showed no malrotation. there were Inflamed Appendix and fecolith at the tip, so appendectomy was done. Despite washing with normal saline there was volvulus 45 cm from the ileocecal valve with whitish serosa so resection of 5 cm from the ileum with end to end anastomosis was done( Figure 4