VOLVULUS OF THE SUPERIOR MESENTERIC TERRI TORY AND CONGENITAL VARIATION OF THE COLIC FIXATION - HUMAN ONTOGENY AND PHYSIOPATHOLOGY - A CASE-REPORT IN ADOLESCENT

Volvulus of the superior mesenteric territory involving the left and t ransvers colon is rare. Congenital variations of intestinal fixation h ave been implicated. We reporte a case observed in an aolescent which illustrates this hypothesis. There was a fixation of pancreato-splenic region and the left colic angle. The duodeno-pancreas and the right, transvers and left colon were mobile. Human ontogenesis of the colon c ould provide a pathophysiologic explanation. During foetal development , the intestin results from unequal growth of the different segments w hich undergo pressure from the different intra-abdominal contents. The fixation of the different parts of the intestin are independent from each other. Specific circumstances are required for variations in cong enital fiation of the colon to led to late events responsible for mech anical volvulus.