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Primary splenic flexure volvulus.

R Mittal1, I Samarasam, S Chandran

  • 1Upper GI Surgical Unit, Department of General Surgery Unit 3, Christian Medical College and Hospital, Ida Scudder Road, Vellore 632004, India.

Singapore Medical Journal
|March 8, 2007
PubMed
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Primary splenic flexure volvulus, a rare condition, can present acutely with gangrene. This case highlights a young man with a massive colonic dilation and a characteristic coffee-bean sign on imaging.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Primary splenic flexure volvulus is an uncommon cause of large bowel obstruction.
  • Volvulus involving the splenic flexure of the colon is particularly rare.

Observation:

  • A 24-year-old male presented with acute abdominal symptoms.
  • Radiographic imaging revealed a massively dilated large bowel loop, exhibiting the classic 'coffee-bean sign'.

Findings:

  • Emergency laparotomy confirmed a distended and gangrenous splenic flexure.
  • The condition was characterized by the absence of the splenic flexure's three primary ligamentous attachments.

Implications:

  • This case underscores the importance of considering rare diagnoses in acute abdominal presentations.

Related Experiment Videos

  • Prompt surgical intervention is critical for managing splenic flexure volvulus with gangrene.
  • Understanding the anatomical basis, such as absent ligamentous attachments, is key for diagnosis and treatment.