Bifocal bowel obstruction by synchronous transverse and sigmoid colon volvulus: A case report and qualitative review of the literature

Abstract

Introduction: Synchronous volvulus of the transverse and sigmoid colon is an exceedingly rare clinical presentation. The dual location of strangulation constitutes a critical surgical emergency due to the heightened risk of intestinal necrosis and septic shock. Given the rarity of this condition, there is a notable paucity of detailed information in the literature, and the management strategies are poorly codified.

Observation: We report the case of a 23-year-old man with a history of bowel transit disorders (diarrhea and constipation), who was admitted as an emergency with typical signs of acute large bowel obstruction. Initial diagnosis of sigmoid volvulus was retained; however, intraoperative findings revealed an associated volvulus of both the transverse and sigmoid colon. A left colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful.

Discussion: Synchronous volvulus of the transverse and sigmoid colon is an extremely rare occurrence; it should be considered as one of the differential diagnoses of acute large bowel obstruction. There is scarcity of information in the literature regarding synchronous sigmoid and transverse colon volvulus.

Conclusion: Synchronous volvulus of the transverse and sigmoid colon is an exceedingly rare clinical entity. Diagnosing this condition can be difficult and the management effectiveness remains controversial. It is presumed that sigmoid volvulus is the initial event; therefore, emphasizing the need for early surgical intervention for sigmoid volvulus could potentially improve outcomes.

Keywords: Obstruction; Sigmoid; Synchronous; Transverse; Volvulus.