A 35-year-old man with no history of interest presented to the emergency department complaining of nausea, vomiting and severe diffuse abdominal pain of sudden onset for 24 hours.
The patient was afflicted with a discreetly distended abdomen and tender abdomen. The patient defended palpation and intestinal silence.
Laboratory tests revealed mild leukocytosis 12.4 x 109/L with neutrophilia and metabolic acidosis.
A plain abdominal X-ray in the standing position showed dilated loops with no evidence of pneumoperitoneum.
Abdominal ultrasound showed abdominal gas and thin loop dilation.
An emergency exploratory laparotomy was performed, finding free dark liquid in the cavity and large dilation of thin loops and colon.
Changes were also observed in ischemic coloration of ileal loops and sigma forming a sigmoid sigmoid colonized node.
Performing pressure with needle of the dilated segments, en bloc resection of ileal and sigmoid segments diagnosed with ileo-ascending anastomosis and terminal anastomosis.
The patient had a favorable evolution despite extensive ileocolic necrosis.
