title: Small intestinal volvulus following laparotomy for endometrial clear cell carcinoma in a woman with a past history of total gastrectomy and Roux-en-Y anastomosis for gastric carcinoma.
abstract: BACKGROUND
  Small intestinal volvulus is a rare complication following Roux-en-Y anastomosis.
  
  
  METHODS
  A 63-year-old woman was diagnosed with small intestinal volvulus following laparotomy for clear cell carcinoma of the endometrium. Her past medical history included a total gastrectomy and antecolic Roux-en-Y anastomosis for Duke's B gastric carcinoma. Operative findings were of transmesenteric herniation of the ileum through the Roux-en-Y small intestinal mesenteric window, with metastatic deposits fixing the hernia at its base to create a volvulus. The proximal transverse colon was very dilated and thin due to partial obstruction by the volvulus. Her treatment involved adhesiolysis and unraveling of the small intestinal volvulus.
  
  
  CONCLUSIONS
  This is the first case report of a small intestinal volvulus following a Roux-en-Y anastomosis involving a metastatic gynacological malignancy.
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Carlton, Victoria, Australia.
authors.forename: Georgiana S M
authors.initials: GS
authors.lastname: Chin
authors.forename: Robert
authors.initials: R
authors.lastname: Heng
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Neesham
authors.forename: Rodney W
authors.initials: RW
authors.lastname: Petersen
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000601:surgery*; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007813:Laparotomy / Q000009:adverse effects*; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000150:complications / Q000556:secondary; D013274:Stomach Neoplasms / Q000601:surgery*