A Case of Transverse Colon Volvulus

Hideo Yamanari, Toshio Shimayama, Toshinori Sakurai, Mikio Kanemaru and Youichirou Mori

Department of Surgery, Miyazaki Medical Association Hospital

A 32-year-old woman was admitted to the hospital because of abdominal pain, vomiting and abdominal distension. She had suffered from cerebral palsy and mental retardation since birth. Abdominal X-ray films reverled marked dilatation of the ascending colon and transverse colon. A contrast enema demonstrated an abrupt obstruction at the distal transverse colon. A characteristic bird-beak deformity was seen, and a diagnosis of transverse colon volvulus was made. An emergency laparotomy showed the volvulus of the transverse colon with a 180°torsion. The detorsioned bowel was viable. Resection of the transverse colon with a primary end-to-end anastomosis was performed. Transverse colon volvulus is a rare disease that accounts for approximately 4% of all colonic volvuli. In a review of Japanese literature, 36 cases of transverse colon volvulus were found. Out of these cases, 14 patients (39%) had cerebral palsy or mental retardation as an underlying disease. Chronic bowel movement dysfunction predisposes an individual to volvulus, and detorsion without a colectomy has a high recurrence rate. Colonic resection should be performed to prevent recurrence.

Key words
transverse colon volvulus, volvulus of the transverse colon, cerebral palsy

Reprint requests
Hideo Yamanari Department of Surgery Miyazaki Shigun Ishikai Hospital 738-1 Funado, Shinbeppu-cho, Miyazaki, 880-0834 JAPAN

Accepted
September 19, 2001

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