A Rare Condition of Simultaneous Occurrence of Sigmoid and Transverse Colon Volvulus.

Hossein Torabi,Rona Ghaffari,Kasra Shirini

doi:10.7759/cureus.20250

Abstract

Volvulus of the colon is the third important reason for colon obstruction, which can occur in different parts of the colon for various reasons and can lead to ischemia and necrosis of the colon wall tissue. In this article, we are going to describe a simultaneous sigmoid and colon volvulus which was operated on with suspicion of sigmoid volvulus. A 72-year-old patient presented with suddenly severe generalized abdominal pain with a past medical history of inflammatory bowel disease (IBD) and prolonged constipation who underwent laparotomy for suspected colonic volvulus. During the operation, it was found that transverse colon volvulus occurred simultaneously with sigmoid colon volvulus with colon necrosis along its length. Therefore, a total colectomy with ileorectal anastomosis was performed. After one week, the patient was discharged from the surgical ward after tolerating feeding and with stable vital signs. The simultaneous transverse colon and sigmoid volvulus is a rare phenomenon, and there are several ways to diagnose and evaluate this situation. However, none of them can help us diagnose this disease. Unfortunately, no specific algorithm has been designed for the approach in this situation, and it all depends on the patient’s condition. Simultaneous occurrence of the sigmoid and transverse colon can make a high-risk emergency condition that could threaten the patient’s life. Therefore, paying attention to the patient’s symptoms and patient’s condition and clinical findings, with high accuracy and speed and subsequently selecting the best surgical technique, if surgery is necessary, and according to the finding during surgery, especially the extent of necrotic tissue, the most crucial issue in treating the patient.

Highlights

Tumor obstruction and complicated sigmoid diverticulitis are the most common reasons for colonic obstruction
An old man has presented with a synchronous sigmoid and transverse colon volvulus which occurs suddenly
Few cases of simultaneous sigmoid and transverse colon volvulus in different people with and without specific past medical history and various ages have been reported as case reports [2,5]

Summary

Introduction

Tumor obstruction and complicated sigmoid diverticulitis are the most common reasons for colonic obstruction. The simultaneous occurrence of sigmoid and transverse colon volvulus is a rare condition. An old man has presented with a synchronous sigmoid and transverse colon volvulus which occurs suddenly. The patient had severe and progressive distension He had severe and generalized tenderness in the abdomen with a predominance of epigastric, but rebound or guarding were not detected. His past medical history represented that the patient has had inflammatory bowel disease (IBD) since seven years ago. The patient was discharged from the surgical service in good general condition after tolerating PO and defecation

Discussion

Conclusions

Findings

Disclosures

Ballantyne GH