[Jejunal lipomatosis with intussusception and volvulus. A case report]

Primary midgut volvulus in adults: report of two cases and review of the literature

INTRODUCTION

This is a report of two male patients (35 and 54 years old, respectively) admitted to our surgical department with signs of small-bowel obstruction.

CASE PRESENTATIONS

Diagnostic workup with plain abdominal radiographs and, more specifically, computed tomography suggested the possibility of bowel rotation. In order to exclude any possibility of associated intestinal ischemia, both patients underwent exploratory laparotomy, which revealed a midgut volvulus without any associated obvious cause or pathology.

DISCUSSION

Both patients had an eventful outcome. Epidemiologic characteristics, clinical presentation, diagnostic workup, surgical treatment, and morbidity-mortality rates of small-bowel volvulus have been reviewed and thoroughly discussed.

Jejunal lipoma with intermittent intussusception revealed by partial obstructive syndrome

Jejunojejunal intussusceptions are not very common in adults, and unlike in children, a lead point is usually found. The clinical presentations in adults tend to be more chronic or intermittent, and they include obstructive syndrome, abdominal cramps, gastrointestinal bleeding, or palpable abdominal mass at physical examination. These unspecific symptoms often lead to late diagnosis after many investigations or even only after an inappropriately extensive surgery. We report the rare case of a 37-year-old female with intermittent bowel obstruction due to jejunojejunal intussusception secondary to the lipoma. The main clinical signs of this uncommon pathology are presented together with the necessary paraclinical investigations that enable surgical treatment.