title: Strangulation caused by a small bowel epiploic appendage: report of a case.
abstract: While many recent cases of colonic epiploic appendage causing acute abdomen have been reported, such appendages of the small bowel are extremely rare. We present a 59-year-old woman in whom a small bowel epiploic appendage caused volvulus. She presented with abdominal pain and vomiting in the absence of previous abdominal operations. A diagnosis of small bowel obstruction from strangulation was made. Laparotomy disclosed bloody peritoneal fluid and a closed loop of strangulated small intestine. An adherent band composed of an epiploic appendage and intestine had completely encircled a loop of jejunum, leading to obstruction. This band was released, and approximately 80 cm of gangrenous bowel was resected. Four epiploic appendages 5-6 cm in length were attached to the ileum at the mesenteric border, beginning at a point 70 cm proximal to the terminal ileum.
authors.affiliation: Department of Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nemoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshizawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Hibi
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Saito
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sanada
authors.forename: Genshu
authors.initials: G
authors.lastname: Tate