The first case of splenic flexure volvulus treated with reduced port surgery using single-incision laparoscopy

Splenic flexure volvulus (SFV) is a rare disease. We encountered a case of SFV, caused by congenital anomalies and persistent constipation.

A 43-year-old woman with a 35-year history of persistent constipation presented to the emergency department with acute lower abdominal pain. She had no past surgical history, and her vital signs were stable. A contrast-enhanced computed tomography (CE-CT) scan confirmed the SFV diagnosis. We initially performed endoscopic repositioning. To prevent recurrence, a laparoscopic left hemicolectomy was then carried out using reduced port surgery (RPS). She experienced no postoperative complications and was discharged seven days post-surgery.

While SFV is typically managed through endoscopic repositioning followed by definitive surgical intervention to prevent recurrence, we successfully employed RPS in this case. Patients with SFV might be prime candidates for RPS due to the non-attachment of the descending colon to the retroperitoneum. Additionally, since SFV is a benign condition that doesn't necessitate lymph node dissection, it aligns well with the capabilities of RPS. Postoperatively, the patient experienced improved constipation symptoms. We hypothesize that this SFV was a result of a combination of factors: intestinal over-length, chronic constipation, and the loose adhesion of the descending colon to the retroperitoneum.

This case demonstrates that RPS can be efficacious in treating SFV.