Three-Year Chronic Simultaneous Separated Triple Large Bowel Volvulus in a Middle-aged Woman: A Case Report

Abstract

This case has been reported in line with the SCARE 2020 criteria. The volvulus of the transverse colon is rare when compared with the cecal and sigmoid volvulus. Cases involving simultaneous volvulus of the transverse colon and another colonic segment are extremely rare. In adolescents, sigmoid volvulus is rare, and because of this, diagnosis is usually missed or delayed. Volvulus is commonly defined as a twisted loop of the intestinal bowel and associated mesentery around a fixed point at its base. Surgery is the main course of treatment for volvolus, ranging from simple detorsion to right colectomy. Sigmoid volvulus remains an uncommon cause of intestinal obstruction among adolescents. A high index of suspicion is necessary to reach a diagnosis and manage accordingly. A delay in diagnosis can lead to complications such as necrosis and perforation of the twisted colon. Caecal volvulus is a rare cause of bowel obstruction, mainly caused by an exceedingly mobile caecum. Early diagnosis can be difficult due to its unspecific symptoms. Computed tomography (CT) plays a major role in diagnosis. The main course of treatment is surgical, and modalities depend on various factors such as patient status and perioperative findings. Currently laparoscopic evolution continues to reduce postoperative morbidity. Transverse colon volvulus is an uncommon cause of intestinal obstruction. It is a surgical emergency that can lead to bowel infarction, peritonitis, and death.

Our case was a 52-year-old woman just with abdominal distention. We performed CT for her and found triple volvulus of the large bowel. In history, she had signs for 10 days in 3 years before. We operated on her, and a total colectomy and anastomosis of the small bowel to rectum was done and discharged her healthy.

The surgical options in the management of acute large bowel obstruction, as a consequence of transverse colon volvulus, are one- or two-stage procedures.