Volvulus of the transverse colon in an octogenarian veteran

Abstract

In the USA, the third leading cause of a large bowel obstruction in adults is volvulus with torsion occurring commonly in the sigmoid and the cecum. Transverse colonic volvulus is exceedingly rare and specific involvement of the splenic flexure is even more uncommon. In the present report, we discuss a Veteran octogenarian who presented with a long-standing history of constipation, but then developed an acute abdomen from a large bowel obstruction. At laparotomy, he had a double closed loop obstruction with volvulus of the splenic flexure. The colon at the splenic flexure was ischemic with patchy areas of necrosis, but no perforation. He underwent a subtotal colectomy with an ileostomy. This case illustrates the need for prompt intervention of this unusual entity. Current trends in the incidence, management, morbidity and mortality are discussed.

Transverse colon volvulus post colonoscopy: a case report

“…The mechanism of how colonoscopy results in volvulus is not well understood, but in these patients, risk factors included abnormal/absence fixation of the caecum, and redundant colon. 15 While the evidence suggests that there is a greater risk of recurrence in patients with TCV who do not undergo a resection, the decision was made in this case not to proceed to a resection. This decision was based on the operative findings of adequate fixation of both the hepatic and splenic flexures, and the precipitating event of a colonoscopy to cause volvulus of the transverse colon.…”

Cecal perforations due to descending colon obstruction (closed loop): a case report and review of the literature

“…Most of the reported literature on diastatic perforations proximal to an obstructing colonic pathology was related to colorectal cancers. Only three cases were reported for closed-loop colonic obstruction causing cecal perforation in NCBI/PubMed database [8][9][10].…”