Abstract
Volvulus of the transverse colon is very rare and often develops in patients with mental and physiological growth retardation. We report the case of a 17-year-old boy who developed volvulus of the transverse colon; this patient has X-linked mental retardation with alpha-thalassemia (ATR-X syndrome), diagnosed when he was 3 years old. He was admitted to our hospital because of abdominal distention and vomiting. Abdominal radiography and CT revealed markedly dilated intestines, and the diagnosis of volvulus of the transverse colon was made. Reduction of the torsion was attempted through a transanal long tube but was not successful. Therefore, we performed an emergent surgical detorsion. During the operation, volvulus of the long dilated transverse colon was found and the twisted colon underwent infarction. After the detorsion, resection of the necrotic colon and end-colostomy were performed. His postoperative course was uneventful and he started oral intake on postoperative day 15. No recurrence was found for 6 months later and his bowel habits gradually improved. Early detection and diagnosis of acute abdomen in patients with mental and physiological retardation are difficult. Volvulus of the transverse colon should be considered in cases of acute abdomen developed in such patients.
