VOLVULUS OF THE SMALL-BOWEL - AN UNCOMMON COMPLICATION AFTER LAPAROSCOPIC CHOLECYSTECTOMY

We report here two patients with volvulus of the small bowel after lap aroscopic cholecystectomy (LC), There has been only one case report of a similar condition after LC in the English literature; the patient h ad malrotation of the midgut, Both patients we are reporting had previ ous pelvic surgery resulting in intraabdominal adhesions, Volvulus had occurred along an axis between the mesenteric attachment and the adhe sion to the parietal peritoneum of the involved loop of small bowel, T he creation of pneumoperitoneum could conceivably allow rotation to oc cur, One patient presented with signs of peritonitis from a gangrenous segment of small bowel, The other presented with continued abdominal pain after surgery, Definitive diagnosis was made only at laparotomy, Previous surgery is considered a relative contraindication to LC, alth ough the incidence of morbidity and conversion to open procedure appea r not to be influenced by previous surgery. Surgeons should be aware o f volvulus as a complication after LC in patients who had previous abd ominal surgery.