Volvulus Of Transverse Colon Research Articles

Transverse Colon Volvulus and Hepatic Angle in 29-year-old male: Case report

Transverse Colon Volvulus and Hepatic Angle in 29-year-old male: Case report

Twist of a Lifetime: A Transverse Colon Volvulus

Transverse colon volvulus is a rare but serious cause of large bowel obstruction, often necessitating urgent surgical intervention to prevent complications such as strangulation and perforation. We present a case of a 55-year-old man who presented with a one-day history of abdominal symptoms. Emergency abdominal computed tomography (CT) revealed transverse colon volvulus, leading to immediate laparotomy and successful detorsion with resection of the affected segment. Postoperative recovery was uneventful, and the patient was discharged in stable condition. This case underscores the importance of prompt diagnosis through imaging, particularly CT, in guiding appropriate therapeutic measures. Additionally, the discussion highlights the rarity of transverse colon involvement, predisposing factors, clinical presentations, and the necessity of surgical intervention, emphasizing the higher mortality rate associated with delayed diagnosis.

Transverse colon volvulus presenting as bowel obstruction, atelectasis, and displacement of the right lobe of the liver into the left upper abdominal quadrant: a case report

BackgroundTransverse colon volvulus is an uncommon cause of intestinal obstruction. It is a surgical emergency that can lead to bowel infarction, peritonitis, and death.Case presentationWe report a case of transverse colon volvulus in a 35-year-old Congolese immigrant man who had a rare presentation with features of intestinal obstruction associated with right lung collapse and left mediastinal shift.ConclusionThis case is unusual because it presented with respiratory features that mimicked a pneumothorax in addition to features of intestinal obstruction. The use of point-of-care lung ultrasound was helpful in ruling out a pneumothorax, and this could help avoid situations such as unintentional chest drain insertions by other professionals who may encounter a similar case. Because transverse colon volvulus is rare, a high level of suspicion and awareness is required to make an accurate diagnosis.

Transverse colon volvulus post colonoscopy: a case report

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.

A Young Man With Epigastric Abdominal Pain

A Young Man With Epigastric Abdominal Pain

Transverse Colon Volvulus: A Case Report and Review of the Literature

Background: Transverse colon volvulus is an uncommon cause of bowel obstruction. The total number of cases reported in the literature is 100. It constitutes a surgical emergency since it can lead to bowel infarction, peritonitis, and death if not diagnosed at once. It seemed appropriate to report this case that was treated at the Department of Visceral Surgery A, Lucien Hussel Hospital in Vienne, France Case presentation: We report a rare case of transverse colon volvulus in a 42-year-old Arabic man, with no particular history, who presented to our emergency department with a 5-day history of constipation, progressive abdominal pain, nausea, and vomiting. His last bowel movement had been 3 days ago. Abdominal radiography showed a large bowel obstruction with a “U-shaped” loop in the left upper abdomen. Abdominal computed tomography was not performed because of impaired renal function. He was operated on urgently after conditioning and the diagnosis of a transverse colon volvulus was done intraoperatively. Rotated in a 360° clockwise direction on its mesentery, the bowel was intact without signs of ischemia. An extended right hemicolectomy was carried out with end-to-side ileocolic anastomosis. Through this case, we will try to discuss its physiopathology, etiologies, diagnosis, and management in emergencies. Conclusion: This case is unusual because no etiological factor has been found. Its diagnosis can be difficult and management effectiveness remains controversial. It is important to highlight this case and those of the literature, as many surgeons may have never seen a case of transverse colon volvulus. Volvulus of the transverse colon may therefore not be considered in the differential diagnosis of recurrent intermittent abdominal pain or acute intestinal obstruction. Prompt recognition with emergency intervention constitutes the key to a successful outcome.

The Outcome of Emergency Surgery among Patients with Large Bowel Volvulus (LBV)

Introduction: volvulus is a twisting or axial rotation of a portion of bowel about its mesentery. Large Bowel Volvulus (LBV) accounts for (5%) of all organic large bowel obstructions and are most common between 50 and 60 years of ages .The reported incidence of the various forms of LBV, (59%) for sigmoid volvulus (SV), (39%) for caecal volvulus (CV) and (2%) for transverse colon volvulus. The diagnosis of acute LBV can be challenging because its clinical presentation has low specificity compared with other non-traumatic abdominal pain. Emergency surgery is the appropriate treatment for those who present with diffuse peritonitis, intestinal perforation or ischemic necrosis. Aim of the study: To review the comparison and benefits of emergency operative procedures in the treatment of patients with acute large bowel volvulus in the emergency setting. Place and Duration: Department of General Surgery at Azadi-teaching hospital in Kirkuk city from December 2008 to December 2013. Patients and Methods: Total 48 patients; 31 male (64.6%) and 17 female (35.4%) (95.8%) patients were over 55 years of age. were included in the study of which 41 (85.4%) diagnosed preoperatively with acute sigmoid volvulus on emergency laparotomy. The remaining 7 patients (14.6%) with caecal volvulus. The choice of surgical procedure depended on the; large bowel viability, time of presentation following onset of obstructive features, extent of proximal colonic dilatation, co morbid diseases and surgeon’s preference. For acute sigmoid volvulus; 11 patient (27.2%) patients underwent sigmoid resection with primary anastomosis (RPA), 18 patient (43.9%) underwent Hartmann’s procedure and 12 patients (29.3%) operated by sigmoid resection with Paul-Mikulicz. For caecal volvulus; Right hemicolectomy performed for three patients (42.9%), caecopexy in two (28.6%) and caecostomy in other two patients (28.6%). Results: Abdominal distension and constipation occurs in all patients (100%), while (95.8%) presented with abdominal pain and peritonitis in (79.2%) (41.5%) has a previous history of bowel decompression either by endoscopic instruments or deflation by rectal tube with a recurrence rate of (76.0%). Chronic medical illnesses are found in most of the patients. LBV is presented in two forms sigmoid (85.4%) of cases, the rest (14.6%) with caecal volvulus. (33.4%) of cases presented with gangrenous colon while bowel perforation (fecal peritonitis) in (4.2%). The operative procedures ;- one stage Resection with Primary Anastomosis in (26.8%) of patients , two stage operative procedures resection of the volvulus sigmoid with (Hartmann and Paul-Mikulicz done in (73.2%), in caecal volvulus right hemicolectomy (with ileo-transverse Anastomosis done for (42.9%), caecopexy (28.6%) and Caecostomy for 2 patients(28.6%) patients. Postoperative complications; Wound infection in (31.3%) of cases. Anastomotic leak (12.5%). Total mortality occurs in 10 cases (20.8%). Conclusion: In acute LBV emergency surgery is indicated, Hartmann’s procedure is the procedure of choice. The presence of cardiac, renal, or respiratory diseases has a significant impact on the complications, morbidity and mortality of patients undergoing surgery for large bowel volvulus.

Colonic Volvulus

Colonic volvulus accounts for 3 to 5% of bowel obstructions in the United States. Current data reveal sigmoid volvulus as the most common colonic volvulus, followed by volvulus of the cecum, transverse colon, and splenic fixture. Despite a low incidence in the United States, diagnosis, management, and patient outcome depend on an appropriate index of suspicion and adherence to the proposed algorithm highlighting the approach to the patient with colonic volvulus. This review outlines the definition, pathogenesis, and epidemiology of colonic volvulus, as well as its clinical evaluation and treatment. Tables review the demographics of colonic volvulus in the United States, the differential diagnosis of and risk factors for colonic volvulus, important radiographic findings in colonic volvulus, and nonoperative management of sigmoid volvulus. Figures show the types of ileosigmoid knot; plain radiographs of cecal, sigmoid, transverse, and splenic flexure volvulus; contrast enema of cecal, transverse, splenic flexure, and sigmoid volvulus; cross-sectional abdominal imaging of cecal, sigmoid, and transverse colon volvulus and ileosigmoid knot; endoscopic evaluation in sigmoid volvulus; use of an esophageal overtube for placement of a rectal tube; necrotic cecum and transverse colon volvulus in the operating suite; and sigmoid volvulus in an elderly gentleman. This review contains 14 figures, 13 tables, and 165 references Keywords: Colonic volvulus, colonic obstruction, endoscopy, surgical intervention, ileosigmoid knot, splenic flexure volvulus, sigmoid volvulus, transverse colon volvulus, cecal volvulus

Ischemic volvulus of the transverse colon caused by intestinal malrotation: A case report.

IntroductionCongenital Intestinal malrotation is a complex disorder caused by incomplete or abnormal rotation of the intestine during fetal development. Volvulus of the transverse colon secondary to intestinal malrotation is a rare cause of acute abdomen in adults. It has a high risk of mortality, hence the need for an urgent diagnosis and surgical intervention.Case reportWe report an unusual case of volvulus of the transverse colon caused by intestinal malrotation. A 21-year-old women presented abdominal pain with nausea and vomiting. On clinical examination, the abdomen was tympanic to percussion with peritoneal sensitivity. The abdominal X-ray revealed a massive obstruction of the distended large intestine with a “U-shaped” loop. He underwent an exploratory laparotomy that revealed the diagnosis of transverse colon volvulus with intestinal malrotation. His condition was treated surgically by transverse colectomy with colostomy. The patient died on the second day following a hemodynamic instability.ConclusionTransverse colonic volvulus is a rare entity with a high mortality, so it requires urgent diagnosis and surgical intervention.

Transverse colonic volvulus due to mesenteric fibromatosis: a case report

BackgroundColonic volvulus, a condition in which a colonic segment partially twists around its base, is the third leading cause of large bowel obstruction after colonic neoplasms and diverticular disease. However, volvulus of the transverse colon is the rarest type of large intestinal volvulus. Moreover, the occurrence of transverse colonic volvulus secondary to a benign tumor originating from outside the intestine has never been reported. We hereby report a case of transverse colonic volvulus caused by mesenteric fibromatosis.Case presentationA 53-year-old female with a history of rheumatoid arthritis and thyroid tumor presented with abdominal pain for 1 day. Abdominal computed tomography revealed intestinal torsion at the hepatic flexure. Twisted and obstructed mucosa of the transverse colon was observed during colonoscopy, but no tumor invasion of the mucosal surface was detected. A solid mass of a mesenteric origin with involvement of the transverse colon was observed during surgery. The mass was diagnosed surgically as transverse colonic volvulus induced by a mesenteric tumor. Hence, the patient underwent a right hemicolectomy. Histopathological results indicated mesenteric desmoid-type fibromatosis. The postoperative recovery was uneventful, and the patient was discharged 8 days after surgery.ConclusionsAlthough mesenteric fibromatosis is rare, this disease should be considered when managing transverse colonic volvulus resulting from nonmucosal tumors.

Atypical image of pneumoperitoneum secondary to colon perforation

The case was a 66-year-old female with a diagnosis of bilateral ovarian carcinoma with peritoneal carcinomatosis and liver metastases. She had only undergone one cycle of chemotherapy and could not be given other cycles because of her poor general condition. She was admitted due to intermittent vomiting for a week and severe heartburn, with the last stool passed two days before, presenting abdominal distension and lower abdominal pain, without signs of peritonism and no peristaltic sounds. After performing several complementary tests a computed tomography scan showed a large amount of intra-abdominal air, which was thought to be a possible transverse colon volvulus, that caused extrinsic compression on the stomach. A colonoscopy was performed in an attempt to devolvulate, which was unsuccessful.

Synchronous Volvulus of the Sigmoid Colon and the Transverse Colon: A Case Report at Gabriel Toure University Hospital in Mali

Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-old man who underwent emergency surgery for sigmoid colon volvulus. An intraoperative finding of transverse colon volvulus associated with sigmoid colon volvulus was made. Left and transverse colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful. Synchronous volvulus of the transverse and sigmoid colon is a surgical emergency. The clinical signs are not specific and the discovery is often intraoperative. It is necessary to know how to evoke the diagnosis in a case of sigmoid colon volvulus, to avoid inadequate management with dramatic consequences.

UNUSUAL PRESENTATION OF ACUTE INTESTINAL OBSTRUCTION DUE TO TRANSVERSE COLON VOLVULUS IN LATE PREGNANCY

Transverse colon volvulus is the rarest type of colonic volvulus, with a higher morbidity and mortality rate. In pregnancy, intestinal obstruction due to transverse colon volvulus is rare and seldom reported, and its timely diagnosis can be difficult. We report an unusual case of transverse colon volvulus in a young female at late-term pregnancy. A 28-years-old, pregnant woman, gravida 2, para 1, at 34 weeks of gestation, presented with progressive abdominal pain and distention, commencing about 12 hours prior to admission, associated with vomiting and obstipation. Vital signs were stable. However, the abdomen was asymmetrically hugely distended. The initial abdominal ultrasound showed a single viable intrauterine fetus and dilated loops of bowels. As fetal distress progressed throughout the admission, a laparotomy was performed, which revealed an unexpected transverse colonic volvulus. Resection of the twisted segment and primary anastomosis were performed, followed by a cesarean section to deliver the baby. The mother made a satisfactory recovery. Although this patient’s preoperative clinical findings suggested colonic obstruction, the diagnosis of transverse colonic volvulus was only made intraoperatively and has seldom been previously described. Chronic constipation, the enlarging uterus, and the anatomical redundancy of the transverse colon may have been contributing factors. Transverse colon volvulus in late pregnancy is uncommon. Early diagnosis and prompt surgical intervention can significantly minimize maternal and fetal mortality.

360 Degree Twisted Transverse Colon in a Neurological Impaired Girl with a History of Chronic Constipation - A Case Report

Introduction: Transverse colon volvulus is an uncommon cause of bowel obstruction. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation, and congenital megacolon. Case report: We presented a transverse colon volvulus in a 14-year-old girl with mental retardation. Chronic constipation in neurologically impaired patients was a risk factor predisposing to volvulus. The girl was admitted to our Clinic because of problems that last 4-5 days and was followed by abdominal pain, vomiting and lack of stool. Vomiting was once a day. She was sub febrile up to 37.6°C. On examination, the abdomen was distended, tense, diffusely painful. During the surgery, a 360° clockwise volvulus of the transverse colon was found. After the reduction of volvulus, an enormous transverse colon was resected and protective ileostomy was formed. In the postoperative period, ileostoma functioned a good. The definitive surgical treatment was done on the 20th postoperative day when the occlusion of the ileostomy and transanal biopsy of the rectum was done, which showed the presence of ganglia cells. The patient was discharged from our institution after 1 month. Conclusion: Pediatric patients with neurological conditions and mental retardation present an increased risk of colon transversum volvulus due to chronic obstruction.

Transverse Colonic Volvulus: A Case Report and Literature Review of a Rare Disease

Obstructions of the large and small bowel are frequently caused by cancer, inflammation, post-surgical adhesions, hernias, and, more rarely, volvulus, representing <10% of all reported cases. Of these, volvulus of the transverse colon (TCV) is found in <5% of all instances of colonic volvulus with delayed diagnosis and treatment resulting in infarction, peritonitis, and death. Given the morbidity and the fact that TCV most often develops acutely, diagnosis of this condition is considered to be a surgical emergency. Common surgical procedures to correct this often involve urgent exploratory laparotomy, followed by either colopexy or colectomy with subsequent creation of colostomy or anastomoses. This is a review of all of the treatment and complications of transverse colonic volvulus published in the last 75 years.

Simultaneous Volvulus of Transverse Colon and Cecum in a Patient With Down Syndrome: A Case Report

Volvulus is a rare cause of intestinal obstruction and occurs mostly in sigmoid colon and cecum. It is more common in patients with Down syndrome. In this condition, it is even more challenging to diagnose the cause of intestinal obstruction through history and physical examination alone. Early diagnosis and intervention are critical in this condition to prevent serious side effects. Simultaneous volvulus is a sporadic case in the surgical entity. We report a very rare case of simultaneous volvulus of cecum and transverse colon, its management, and outcomes in a 20-year-old known case of Down syndrome.

Transverse colon volvulus presenting as bowel obstruction: a case report

BackgroundTransverse colon volvulus is an uncommon cause of bowel obstruction. The total number of cases reported in the literature is 100. It constitutes a surgical emergency since it can lead to bowel infarction, peritonitis, and death if not diagnosed at once. It seemed appropriate to report this case that was treated at the Department of Visceral Surgery A, University Hospital Center Hassan II of Fez in Morocco.Case presentationWe report a rare case of transverse colon volvulus in a 42-year-old Arabic man, with no particular history, who presented to our emergency department with a 5-day history of constipation, progressive abdominal pain, nausea, and vomiting. His last bowel movement had been 3 days ago. Abdominal radiography showed a large bowel obstruction with a “U-shaped” loop in the left upper abdomen. Abdominal computed tomography was not performed because of impaired renal function.He was operated on urgently after conditioning and the diagnosis of a transverse colon volvulus was done intraoperatively. Rotated in a 360° clockwise direction on its mesentery, the bowel was intact without signs of ischemia. An extended right hemicolectomy was carried out with end-to-side ileocolic anastomosis.Through this case, we will try to discuss its physiopathology, etiologies, diagnosis, and management in emergencies.ConclusionThis case is unusual because no etiological factor has been found. Its diagnosis can be difficult and management effectiveness remains controversial.It is important to highlight this case and those of the literature, as many surgeons may have never seen a case of transverse colon volvulus. Volvulus of the transverse colon may therefore not be considered in the differential diagnosis of recurrent intermittent abdominal pain or acute intestinal obstruction.Prompt recognition with emergency intervention constitutes the key to a successful outcome.

Synchronous volvulus of the sigmoid and transverse colon in a 26-year-old male

We present a 26-year-old male patient who presented with complete bowel obstruction and peritonitis. His abdominal X-rays showed grossly distended large bowels with air–fluid levels. A differential diagnosis of sigmoid volvulus was entertained and the patient was taken for an exploratory laparotomy. Intraoperatively, we found a sigmoid volvulus and a concurrent transverse colon volvulus. A subtotal colectomy and colostomy was performed. The histopathology results showed mucosal and submucosal congestion, chronic inflammation, and no malignancy or dysplasia. Synchronous volvulus of the sigmoid and transverse colon is an extremely rare. Management includes endoscopic derotation and decompression followed by semi-elective surgery in non-complicated cases. When endoscopic decompression has failed or there is suspicion of necrosis or perforation, surgery is mandatory.

Transverse colonic volvulus in a 16-year-old female with congenital myotonic dystrophy: A case report

Abstract Transverse colonic accounts for 2–4% of all forms of colonic volvulus and has its highest mortality rate (33) [1] , [2] , [3] . Only forty cases of pediatric transverse colonic volvulus have been reported in the literature to date [4] . We report on a 16-year-old female with congenital myotonic dystrophy who underwent operative repair for transverse colonic volvulus, the first reported case of these two entities in combination.

Synchronic Volvulus of Sigmoid and Transverse Colon: A Rare Case of Large Bowel Obstruction

Introduction: Volvulus of two segments of colon has been reported rarely, as either synchronous or metachronous events. Colonic volvulus involving both transverse and sigmoid colon is a rare medical problem frequently dismissed as a cause of large bowel obstruction. Case Presentation: A 73-year-old female presented with colicky abdominal pain, abdominal distension and anorexia for several days. Abdominal radiography showed distended intestinal loops. Patient went under laparotomy and transverse and sigmoid volvulus was discovered. Conclusions: In spite of transverse colon and sigmoid volvulus rarity, it is advised to include these in the differential diagnosis of patients with chronic abdominal pain associated with recurrent bowel obstruction.