Published in:
Open Access 01-12-2012 | Case report
Colopexy as a treatment option for the management of acute transverse colon volvulus: a case report
Published in: Journal of Medical Case Reports | Issue 1/2012
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Introduction
Transverse colon volvulus is an uncommon acute surgical presentation associated with a higher rate of mortality than volvulae at other locations along the colon. Surgical resection or correction is the only treatment, and various methods have been described in case report literature to relieve the volvulus and prevent recurrence.
Case presentation
We present the case of a 25-year-old Caucasian woman who was admitted with a three-day history of abdominal pain, absolute constipation and abdominal distension. Subsequent radiographic and computed tomography imaging revealed right-sided colonic dilatation suggestive of a volvulus. An emergency laparotomy was performed during which the dilated proximal bowel was decompressed and colopexy executed by using the greater omentum to fix the transverse colon at the hepatic and splenic flexures.
Conclusions
Volvulus of the transverse colon is rare but must form part of the clinician's differential diagnosis when encountering a patient with suspected bowel obstruction, especially in younger patients with no previous surgical history. Laparotomy is the treatment of choice and the technique of using the greater omentum as a fixing point for redundant bowel to the lateral abdominal wall is an option that may be considered especially when the bowel appears viable.