Synchronic volvulus of splenic flexure and caecum: a very rare cause of large bowel obstruction

BMJ Case Rep. 2016 Jan 18:2016:bcr2015213029. doi: 10.1136/bcr-2015-213029.

Abstract

Colonic volvulus involving the caecum and splenic flexure of the colon is an extremely rare surgical entity and, as a result, it is rarely entertained as a differential diagnosis for large bowel obstruction. The most common site of volvulus is located at the sigmoid colon (75%) followed by caecum (22%). Rare sites of colonic volvulus include the transverse colon (about 2%) and splenic flexure (1-2%). Synchronous double colonic volvulus is very rare. The presentation of this condition can be similar to the signs and symptoms of large bowel obstruction. CT imaging of the abdomen can be diagnostic; however, the diagnosis is often missed due to the rarity of this condition--in such cases, it can only be made at laparotomy. Management of this condition should be expedited to prevent a fatal outcome. We present the case of a 56-year-old woman with synchronous volvulus of the caecum and splenic flexure of the colon.

Publication types

  • Case Reports

MeSH terms

  • Cecal Diseases / diagnostic imaging*
  • Cecal Diseases / surgery
  • Colon, Transverse / diagnostic imaging*
  • Colon, Transverse / surgery
  • Colonic Diseases / diagnostic imaging*
  • Colonic Diseases / surgery
  • Female
  • Humans
  • Intestinal Obstruction / diagnostic imaging*
  • Intestinal Obstruction / surgery
  • Intestinal Volvulus / diagnostic imaging*
  • Intestinal Volvulus / surgery
  • Middle Aged
  • Tomography, X-Ray Computed