A Case of Transverse Colon Volvulus Occurred after a Sigmoidectomy.

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A 30-year-old woman was admitted to the hospital because of abdominal pain and distension. She was suffering from mild mental retardation and chronic constipation. She had a history of undergoing a sigmoidectomy for sigmoid colon volvulus 4 years before admission, and then Hirschsprung's disease was suspected but not confirmed. Physical examination showed abdominal distension and tenderness, but no sign of peritonitis. Laboratory results including white blood cell count and CRP were normal. Abdominal X-ray examination revealed a markedly dilated ascending and transverse colon. Water soluble contrast enema demonstrated bird beak sign in the splenic flexure of transverse colon. An emergency colonoscopy showed twisted stricture in the same portion. Transverse colon volvulus was diagnosed and an emergency operation was performed. An emergency laparotomy showed volvulus of the transverse colon with a 360° clockwise torsion. Ischemic change was mild and the colon appeared viable, and the association with functional bowel disease was suspected. Detorsion was performed. Transverse colon volvulus is rare, especially multiple case. We present our case with a review of some relevant literature.
日本臨床外科学会の論文