Total small bowel volvulus on incomplete common mesentery, an exceptional complication in geriatric patients: A rare case report

Introduction and importance: The incomplete common mesentery, resulting from a rotational anomaly, is a rare but potentially life-threatening condition. This congenital anomaly is characterized by persistent embryonic bowel arrangement and an extremely short mesentery root. Complications typically manifest during neonatal or pediatric stages, with limited occurrences in adulthood. Herein, a compelling case of an 83-year-old male with small bowel volvulus and incomplete common mesentery, underscoring the critical importance of recognizing and addressing rare but potentially life-threatening complications in the geriatric population. Case presentation: An 83-year-old male, post-prostatectomy, presented with acute abdominal distress, indicating small bowel volvulus associated with incomplete common mesentery. Dehydration signs were evident on admission, and imaging confirmed the diagnosis. Urgent surgical intervention, including the Ladd procedure, successfully resolved the condition with a six-day recovery. Clinical discussion: Fetal digestive tract rotation anomalies lead to incomplete common mesentery, posing risks of volvulus. Complications, whether acute or chronic, require timely recognition. Diagnostic modalities, including the "whirlpool " sign on imaging, play a vital role. The Ladd procedure remains the standard treatment, addressing mesenteric anomalies and preventing recurrence. Conclusion: This case highlights the critical nature of small bowel volvulus with incomplete common mesentery, emphasizing the importance of recognizing and managing this rare condition promptly. Awareness, diagnostic accuracy, and timely surgical intervention are crucial for favorable outcomes, particularly in the geriatric population.