Metachronous volvulus of the splenic flexure: a rarer entity

Dhamnaskar, Suchin; Sawarkar, Prashant; Mandal, Sumit; Vijaykumaran, Preeti

doi:10.18203/2349-2902.isj20180383

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…In children, as in adults, simple detorsion is associated with a 30% rate of recurrence. 15,16 Thus, the management of choice in children should be resection with primary anastomosis. However, detorsion (with fixation, or with ileostomy, or with elective resection) have been described in children with variable recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

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Volvulus of the Transverse Colon

Huerta

Pickett

Mottershaw

et al. 2021

The American Surgeon™

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Background In the United States, the third leading cause of a large bowel obstruction (LBO) is colonic volvulus with torsion occurring most commonly in the sigmoid and the cecum. Transverse colonic volvulus (TCV) is exceedingly rare and specific involvement of the splenic flexure (SFV) is even less common. The present analysis was undertaken to interrogate current trends in presentation, management, and outcomes of TCV. Methods In the present report, the world literature was reviewed for the past 90 years (1932 to 2021). We conducted a systematic review to identify all cases of TCV following the PRISMA guidelines. Results We identified 317 cases of TCV. This included SFV (n = 75), TCV in pediatric patients (n = 63), TCV in pregnant patients (n = 8), and TCV associated with other pathology such as Chilaiditi’s syndrome (n = 11). Compared to sigmoid and cecal volvulus, TCV was rare (.94%). It affected slightly more women (54%) than men, commonly in their third decade of life (37.7 ± 23.8). The clinical presentation and diagnostic imaging were consistent with LBO. Compared to sigmoid volvulus, there was a limited role for conservative management and colonoscopic decompression was less effective. The most common operation was segmental resection (25%). Mortality was (20%) commonly because of cardiopulmonary complications and affected more women (63%). The average age of this cohort was 55.7±24.6 years old. Discussion Our review showed that TCV is an uncommon surgical entity. The diagnosis is likely to be made at laparotomy. Prompt recognition is paramount in preventing ischemia necrosis and perforation. Compared to sigmoid and cecal volvulus, the mortality for TCV remains high.

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Section: Discussionmentioning

confidence: 99%

“…Simultaneous (synchronous) volvuli involving the transverse colon, including the stomach, 3,79,144 the cecum, 58,124,138 the sigmoid, 66,114,129,135,142,147,149,181,182 the right colon, 181,182 and the spleen, 24 were recognized. Metachronous cases to the sigmoid 15,34,66,112 and cecum 55 were also identified.…”

Section: Synchronous Volvulimentioning

confidence: 99%