2018 Volume 38 Issue 5 Pages 921-924
A 73-year-old woman visited our hospital with a history of abdominal pain persisting from the previous day. Abdominal contrast-enhanced computed tomography showed dilatation of the transverse colon and a positive whirl sign, and we made the diagnosis of volvulus of the splenic flexure of the colon. Since we did not find any apparent signs of bowel necrosis, we attempted endoscopic reduction, but failed. The abdominal pain was relieved, but it recurred 8 hours later. Endoscopic reduction was attempted again, but failed again, and we placed a transanal ileus tube in the dilated colon. Computed tomography showed pneumatosis intestinalis of the splenic flexure of the colon and edema of the mesentery, therefore, we performed emergency surgery. The splenic flexure of the colon was? expanded and twisted about 180 degrees counterclockwise, but there was no evidence of bowel necrosis. We performed partial resection of the splenic flexure of the colon and a functional end-to-end anastomosis. Although there is no report of laparoscopic surgery performed for volvulus of the splenic flexure of the colon, we consider that the procedure can be performed safely for this condition.
