A Case of Transverse Colon Volvulus Originating From a Mesenteric Cyst Complicated by Pseudomembranous Colitis in a Patient With Cornelia de Lange Syndrome

Abstract

The patient was a 23-year-old female with Cornelia de Lange Syndrome (CdLS) and total intestinal malrotation, with a history of recurrent sigmoid volvulus. She presented with vomiting and loose stools beginning the day before admission, followed by massive hematochezia at night. CT scan revealed diffuse colonic edema, which raised suspicion of colonic volvulus, necessitating surgical intervention. A preoperative test was positive for Clostridium difficile (CD) toxin; therefore, the treatment for pseudomembranous colitis was initiated concurrently. Intraoperatively, a 270-degree rotation of the transverse colon around its shortened mesenteric pedicle was observed, and a mesenteric cyst was identified in the middle of the mesentery. The volvulus was determined to have originated from the cyst. The mesenteric cyst was resected, and the shortened transverse colon mesentery was adequately expanded to prevent recurrence. The patient had an uneventful postoperative course and was discharged on postoperative day 14. Colonic volvulus is a known complication in CdLS; however, transverse colonic volvulus secondary to a mesenteric cyst is rare. Here, we report a case of recurrent colonic volvulus that progressed to a severe condition requiring surgical intervention, along with a review of the literature.