Sub-acute transverse colon volvulus an exceptional cause of large bowel obstruction: Case report

Elbakouri, Abdelilah; Lafkih, Oussama; Andaloussi, Zineb Abbad El; Bouali, Mounir; Elhattabi, Khalid; Bensardi, Fatimazahra; Fadil, Abdelaziz

doi:10.1016/j.amsu.2021.01.102

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…1 Risk factors for the development of TCV include congenital (malrotation, abnormal fixation), chronic constipation, non-fixation, pregnancy, Chilaiditi's syndrome, and pseudomembranous colitis. 10 Unlike sigmoid volvulus, it is often not amenable to colonoscopic decompression, and in cases where this has been first line treatment, there is a high rate of recurrence. 11 Therefore, mainstay of management should be similar to that of caecal volvulus, where there is operative fixation either with an extended right hemicolectomy, or segmental resection.…”

Section: Discussionmentioning

confidence: 99%

Transverse colon volvulus post colonoscopy: a case report

Long

Mouline²

2023

Int Surg J

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Colonic volvulus accounts for 15-20% of large bowel obstructions. A very small percentage of colonic volvulus occur in the transverse colon and splenic flexure (<5%). Colonic volvulus is a surgical emergency and requires urgent decompression to prevent bowel ischaemia and perforation. The incidence of colonic volvulus post colonoscopy is rare, and aetiology is believed to be secondary to insufflation in the context of a non-fixed/mobile segment. We present a case of a 75-year-old man who presented to the emergency department with abdominal pain following a colonoscopy. Computer tomography (CT) imaging of his abdomen demonstrated an acute volvulus of the transverse colon. He proceeded to a diagnostic laparoscopy where the volvulus had resolved. The transverse colon was noted to have redundancy, but both the caecal pole and splenic flexure were fixed. The decision was made not to respect the bowel. Transverse colon volvulus is a rare occurrence, and accurate assessment and investigation of patients presenting with obstructive bowel symptoms is essential to allow prompt surgical management and prevent ischaemia and bowel wall perforation.

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Section: Discussionmentioning

confidence: 99%

Transverse colon volvulus post colonoscopy: a case report

Long

Mouline²

2023

Int Surg J

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“…CT abdomen is usually indicated in a patient with suspected volvulus or obstructed incisional hernia. CT also will demonstrate the presence of bowel enhancement or any features of the development of bowel gangrene [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Volvulus of the Transverse Colon Herniated Through Drain Site

Prakash¹,

Shaikh²,

Prakash³

et al. 2023

Cureus

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Herniation of the transverse colon and volvulus of it occurring through the previous surgical drain site, presenting as intestinal obstruction, has never been reported. We present an 80-year-old female who complained of abdominal swelling for 10 years. She started developing pain abdomen for 10 days and obstipation for three days. Abdominal examination showed a tender mass in the right lumbar region, with all borders being distinct, and there was no cough impulse. There is a lower midline scar from the previous laparotomy and a small scar over the swelling (drain site). Imaging studies were diagnostic of large bowel obstruction due to the herniation and volvulus of the transverse colon through the previous surgical drain site. She underwent laparotomy, derotation of transverse colon with hernia reduction, and onlay meshplasty. She had an uneventful postoperative course and was discharged.

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“…The first instance of a congenital transmesenteric hernia presenting in an adult was reported by Moulay et al in 1971 [4]. The incidence of congenital IHs presenting with SBO and bowel ischemia in adulthood is extremely rare, with <30 case reports in published literature up to 2023, to the best of our knowledge [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Since there are so few case reports documented and published, no systematic reviews outlining the presentation, ideal course of management, or outcomes are available for comparison.…”

Section: Cect: Contrast-enhanced Computed Tomographymentioning

confidence: 99%

“…Congenital IHs are rarer, even more so in adults, accounting for barely 8% of all iHs, usually due to embryological or developmental defects, often undiagnosed, and require a high index of clinical suspicion [2]. Congenital IHs are a common cause of SBO in infants and pediatric age groups, but are extremely rare among adults, with only 28 cases documented in published literature [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. They often remain undiagnosed, usually being an intra-operative diagnosis, and hence require a low threshold for surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Congenital Transmesenteric Hernia With Closed-Loop Small Bowel Obstruction and Intestinal Gangrene in an Adult

Songadkar,

Hansalia,

Pathak

et al. 2024

Cureus

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Internal hernias (IHs) are defined as the protrusion of the intestine through an aperture in the peritoneal ligament, mesentery, or the omentum, without traversing the fascial planes and leading to encapsulation of the protruded intestine within another compartment of an otherwise intact abdominal cavity. Internal hernias can be acquired or congenital. Congenital internal hernias resulting in small bowel obstruction are extremely rare, even more so in adults, occurring usually due to embryological or developmental defects, often undiagnosed, and requiring a high index of clinical suspicion. We report a rare case of a 22-year-old young adult with transmesenteric hernia of distal ileum through a congenital distal ileal mesenteric defect resulting in closed-loop small bowel obstruction and distal ileal gangrene, managed with resection and end-ileostomy, followed by stoma reversal one month later. It requires a high index of suspicion and remains a surgical emergency due to its predilection for intestinal gangrene and small bowel obstruction, with a high mortality rate due to delayed presentation and diagnosis.

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Sub-acute transverse colon volvulus an exceptional cause of large bowel obstruction: Case report

Cited by 5 publications

References 11 publications

Transverse colon volvulus post colonoscopy: a case report

Transverse colon volvulus post colonoscopy: a case report

Volvulus of the Transverse Colon Herniated Through Drain Site

Congenital Transmesenteric Hernia With Closed-Loop Small Bowel Obstruction and Intestinal Gangrene in an Adult

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