Article Text

Rare disease
Small bowel volvulus in a patient with chronic idiopathic intestinal pseudo-obstruction
  1. Haney Youssef1,2,
  2. Sidi H Rashid3,
  3. Enrique Collantes Cellador4,
  4. Phil Baragwanath5
  1. 1
    Department of General Surgery, New Cross Hospital, Wednesfield Road, Wolverhampton WV10 0QP, UK
  2. 2
    Abbotsford Road, Ashby de la Zouch LE65 1AE, UK
  3. 3
    Department of Radiology, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK
  4. 4
    Department of Anaesthesia, The Royal London Hospital, Whitechapel Road, London E1 1BB, UK
  5. 5
    Department of General Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2AX, UK
  1. H Youssef, haney{at}doctors.org.uk

Summary

Chronic idiopathic intestinal pseudo-obstruction (CIIP) is a rare syndrome of ineffectual gut motility associated with clinical, endoscopic and radiological exclusion of mechanical causes, as well as evidence of air–fluid levels in distended bowel loops. A case of small bowel volvulus in a patient with an established diagnosis of CIIP is presented. The case is illustrated by images of operative findings and computed tomography scan reconstruction, showing the classical appearances of small bowel volvulus. The patient recovered well after surgery and is maintained on parenteral nutrition. CIIP is a heterogeneous disorder in which the primary aims of management are nutrition, pain control and the avoidance of unnecessary repeated laparotomies. However, even in the presence of an established diagnosis of CIIP, surgeons should be vigilant to the possibility that an operable mechanical obstruction may still occur.

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Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

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