Highlights Adult Hirschprung’s Disease (AHD) can be a difficult diagnosis to make, due to its rarity. We report a possible case of AHD and conduct a systematic review of the literature. A typical patient would be male, average age of 30-years-old, with a history of chronic constipation complicated by repeated acute obstruction. Surgical resection, such as with Duhamel’s procedure, is curative. Early identification of these patients and definitive diagnoses would eliminate unnecessary and ineffective surgical interventions.

Colonic volvulus, where the colon twists around its mesentery, commonly occurs in the sigmoid and cecum. However, colonic volvulus of the splenic flexure is quite rare. Reported cases are limited but suggest that prolonged constipation in patients with either congenital anomalies, history of prior abdominal surgery, and or psychiatric history are described as common risk factors for large bowel volvulus. Here, we discuss a case of a 56-year-old man with a history of chronic constipation and no previous abdominal surgeries who presented to the emergency department with abdominal pain and distention. Further workup including a computed tomography imaging and decompressive via limited colonoscopy confirmed diagnosis of colonic volvulus of the splenic flexure. Surgical management of colonic volvulus is patient specific but invariably involves partial colectomy, as was performed in this case.