A rare metachronous colonic volvulus

Abstract

Introduction: Colonic volvulus is a common cause of large bowel obstruction with the sigmoid colon most commonly affected. Volvulus of  the transverse colon is an uncommon occurrence. Rarer still is a transverse colon volvulus developing after surgery for a sigmoid  colon volvulus. Early diagnosis is critical as delay in detection and intervention is associated with the risk of complications – perforation,  peritonitis, and death.

Case presentation: We report the case of an 86-year-old man who presented with features of large bowel  obstruction 14 months following a sigmoid colectomy for a sigmoid colon volvulus.

Conclusion: A metachronous transverse colonic  volvulus is uncommon. Preoperative diagnosis is challenging as there are no defining radiographic features compared to the volvulus of  the sigmoid colon with the classical omega sign. Most cases are diagnosed intra-operatively. Bowel resection and anastomosis in a single  stage is a safe option.