Acute small bowel volvulus in a 2-month-old infant

Authors

  • Roderick Wouters,

    Corresponding author
    1. Department of Pediatric Surgery, University Medical Center Groningen, Groningen, Netherlands
    • Correspondence

      Roderick Wouters, Department of Pediatric Surgery, BA50, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands.

      Tel: +31-50-3612306; Fax: +31-50-3611745;

      E-mail: pcr.wouters@umcg.nl

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  • Menno Raber,

    1. Department of Pediatric Surgery, University Medical Center Groningen, Groningen, Netherlands
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  • Robertine van Baren

    1. Department of Pediatric Surgery, University Medical Center Groningen, Groningen, Netherlands
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Key Clinical Message

Abdominal cystic lymphangiomas are rare and occur secondary to congenital malformation of the lymphatics, mostly in the mesenterium. Acute or chronic volvulus of the small bowel may occur by traction of the lymphangioma. Therapy includes resection of the lymphangioma and of the small bowel involved.

Question

What is the cause of this volvulus?

A. Lymphoma.

B. Cystic lymphangioma.

C. Mesothelioma.

D. Dermoid cyst.

Answer: B, cystic lymphangioma.

Explanation

On presentation, X-radiograph of the abdomen displayed a distended small bowel. A transverse supraumbilical laparotomy was performed and a volvulus of the small bowel was seen. The lead point of this volvulus was a 7-cm benign cystic lymphangioma, located 15-cm distal of Treitz' ligament. The vital bowel was repositioned and the cyst was resected including a small section of jejunum, which was anastomosed end-to-end. The patient made an uneventful recovery.

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Conflict of Interest

None declared.

Ancillary