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Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...
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Dual-Segment Colonic Volvulus Involving the Sigmoid and Transverse Colon: A Surgical Emergency.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Radiology

Background:

  • Synchronous colonic volvulus is an exceptionally rare condition causing large bowel obstruction.
  • Nonspecific symptoms and overlapping imaging features with isolated volvulus complicate early diagnosis.
  • Delayed recognition significantly elevates risks of ischemia, perforation, sepsis, and mortality.

Purpose of the Study:

  • To present a case of synchronous colonic volvulus involving the sigmoid and transverse colon.
  • To emphasize the diagnostic challenges and critical importance of prompt identification.
  • To highlight the necessity of surgical intervention in managing this life-threatening condition.

Main Methods:

  • Case report of a middle-aged patient with acute abdominal symptoms.
  • Diagnostic workup included physical examination, laboratory tests, abdominal radiography, and contrast-enhanced computed tomography (CECT).
  • Surgical confirmation and management via exploratory laparotomy, resection, and primary anastomosis.

Main Results:

  • CECT revealed the characteristic whirl sign at two distinct sites, confirming synchronous sigmoid and transverse colon volvulus.
  • Exploratory laparotomy confirmed the diagnosis and revealed compromised vascularity in both segments.
  • Successful surgical resection and anastomosis, with an uneventful postoperative recovery.

Conclusions:

  • Synchronous colonic volvulus, though rare, must be considered in acute large bowel obstruction, especially with atypical imaging findings.
  • High index of suspicion and advanced imaging like CECT are vital for timely diagnosis.
  • Prompt surgical intervention is essential to prevent severe complications and improve patient outcomes.