A Rare Case of Total Colonic Volvulus

Abstract

Volvulus is a complete twisting of the colon around its mesenteric vasculature, significantly risking obstruction and advancement to ischemic bowel. The most common areas of volvulus are in the sigmoid and cecum; less commonly, volvulus can occur in the splenic flexure and the transverse colon. A rarer situation involves the simultaneous volvulus of the transverse and sigmoid colon. This case report describes a total colonic volvulus involving the terminal ileum to the junction of the descending and sigmoid colon. To our knowledge, only one other similar case has been reported in the English literature.This is the case of a 59-year-old Caucasian female who presented with gastrointestinal bleeding, hypotension, and abdominal pain. Computed tomography (CT) imaging showed colonic thickening with distention extending from the cecum up to the region of the descending-sigmoid junction, which was suggestive of volvulus. An exploratory laparotomy was performed, and infarcted bowel associated with volvulus involving the cecum, ascending colon, transverse colon, and descending colon down to the sigmoid junctionwas discovered. A subtotal colectomy and ileostomy was performed.