Primary Segmental Volvulus of the Small Bowel -Report of 2 Cases-

소장의 국한적 원발성염전 2례 보고

Primary segmental volvulus of the small intestine is not associated with malrotation, malfixation of the midgut, nor other primary small bowel lesions such as small bowel tumors. This entity is known to be more prevalent in adult and in certain global areas associated with particular diet habits. There have been very few reports in neonates, but not in this country so far. The author reports two cases of primary segmental volvulus. Case 1 was a septic 4-day-old girl with hematochezia due to jejunal volvulus with partial necrosis and panperitonitis. Resection of the segment and Bishop-Koop enterostomy were successful. Case 2 was a 3-day-old boy, who had ileal volvulus with ultra-short length of ileal atresia, probably due to intrauterine segmental volvulus. Limited resection of the atresia and spreading of the mesenteric base were enough to recovery. The rarity of the pathognomonic findings and limitation of the diagnostic workup due to rapid progression limit early diagnosis and good survival rate in this particular condition.

일부 국가에서만 발병 예가 보고된 바 있는 신생아의 국한적인 원발성소장염전을 수술하여 생존시킨 2예를 보고하였다. 진단적인 소견은 갑자기 발병한 신생아 소장폐쇄 소견과 패혈증 및 1예에서만 보인 장관출혈 외에는 특기할 만 한 것이 없었으나 이러한 질환의 가능성을 염두에 두고 신속히 개복술을 시행함이 환자를 살리기 위하여 가장 중요한 점으로 판단되었다.