Colonic volvulus is the third leading cause of large bowel obstruction. About 35% of these are located in the caecum. Though, relatively, a rare cause of obstruction, the incidence of caecal volvulus is steadily increasing at a rate of about 5% per year. Mortality due to caecal volvulus may be as high as 40% especially in the presence of gangrene and sepsis. Clinical presentation may be acute and fulminant or as a mobile caecum syndrome with intermittent abdominal pain. "Whirl," "Coffee bean," and "bird beak" signs seen on computed tomography are pathognomonic. Colectomy is the preferred treatment as it obviates any chance of recurrence. A conservative approach to colectomy such as limited ileocaecal resection and ileostomy formation in critically ill patients or in those with poor physiological reserve may be associated with better postoperative outcomes.

Background Transverse colon volvulus is an uncommon cause of intestinal obstruction. It is a surgical emergency that can lead to bowel infarction, peritonitis, and death. Case presentation We report a case of transverse colon volvulus in a 35-year-old Congolese immigrant man who had a rare presentation with features of intestinal obstruction associated with right lung collapse and left mediastinal shift. Conclusion This case is unusual because it presented with respiratory features that mimicked a pneumothorax in addition to features of intestinal obstruction. The use of point-of-care lung ultrasound was helpful in ruling out a pneumothorax, and this could help avoid situations such as unintentional chest drain insertions by other professionals who may encounter a similar case. Because transverse colon volvulus is rare, a high level of suspicion and awareness is required to make an accurate diagnosis.

Purpose: Intestinal stomas are a common procedure performed in children. They carry a high complication rate which affects the child, family and hospital. This study was aimed at documenting these complications and their associated factors. Methods: This was a cross-sectional study carried out at the paediatric surgery unit of Mulago Hospital which is the main referral hospital in Uganda over a period of one and a half months. It included 131 children whose caretakers were interviewed and children physically assessed for presence of intestinal stoma complications. Results: The mean age was 2 years (SD±1) with a male to female ratio of 1.3:1. Anorectal malformation (ARM) (77/131) was the most common indication for stoma formation followed by Hirschsprungs disease (25/131). Sigmoid colon was the most exteriorised part (104/131) followed by ileum (27/131). Children with intestinal stomas who developed complications were 83/131 with peristomal dermatitis being the most common complication (54/131) followed by stoma prolapse (5/131). The factors associated with intestinal stoma complications were stoma placement after the age of 12 months (OR 10.7, CI 1.47-17.62, p-value 0.019) and exteriolization of the ileum (CI 0-0.66, p-value 0.028). Conclusion: The prevalence of intestinal stoma complications is high in Uganda with stoma placement after the age of one year and having an ileostomy as the associated factors. Sigmoid divided colostomies and prioritization of children with ileostomies for stoma reversal will help to significantly reduce intestinal stoma complications.