A 24-year-old female presented with Chronic Pain in her abdomen since the last 3 days. She was admitted at a nursing home for the same and a CT scan was done to evaluate her condition in details. The CT scan showed Acute Intestinal Obstruction with a serious condition known as a Volvulus, which is the rotation of the intestines around a point, which leads to gangrene of the intestines, if not treated urgently.
The patient was immediately shifted to RHC Wanowrie wherein an emergency surgery was planned for her.
Dr. Pradeep Sharma and Dr Harshvardhan C were the surgeons for the case and an Exploratory Laparotomy, which is the opening of the abdominal cavity, was done.
On Laparotomy, it was seen that the terminal ileum, which is a part of the small intestine, was Gangrenous, and had to be surgically removed. A Vitello-Intestinal band was seen, which is an embryological remnant that usually obliterates by itself. It was this band, which caused the Volvulus along with a Meckel’s Diverticulum, which is an out pouching of the small intestine. The continuity of the bowel was maintained by rejoining the small intestine to the large intestine using staplers. An Appendicectomy was also done, due to Malrotation of the gut, to avoid any confusion in diagnosis if the patient presents with pain abdomen in the future.
A very interesting case, which is not routinely seen in practice and which was life saving for our young patient.
At the time of writing this article, the patient is doing well and has started taking liquid diet.
The above image shows the Gangrenous Bowel seen on opening the abdominal cavity.
The above image shows the final resected specimen with the gangrenous terminal ileum with the Meckel’s Diverticulum and the Vitello-intestinal band.
– Dr Harshvardhan Chaukulkar