Ileal Volvulus with Chronic Obstruction

Volvulus occurs when the intestine twists about an anchor point on its mesentery, often leading to bowel obstruction, ischemia, infarction, or perforation.1 The colon is the most frequent site of volvulus, which has rarely been observed to occur in the small bowel.2 Small bowel volvulus (SBV) is most common in infants and children, typically occurring in those born with an intestinal malrotation.1 SBV rarely occurs in the adult population, accounting for 1 per cent of adult bowel obstructions in the United States between 1998 and 2010, and is associated with a high rate of mortality of 7.92 per cent.1 Early diagnosis and surgical intervention of SBV are necessary to improve positive patient outcomes in patients who present acutely with small bowel necrosis.3 Chronic intermittent SBV is less common and the presentation and treatment are less well defined. The procedure was successful and patient's symptoms have resolved though he remains mildly distended on physical examination. Because of the patient's age and debility, ileostomy closure has not been performed six months after creation of the ileostomy.