A case of transverse colon volvulus in a young woman with intellectual disability: a case report

A better understanding of the clinical presentation and management of transverse colon volvulus is needed to allow earlier diagnosis and improved outcomes. Here, we report on a woman with transverse colon volvulus successfully treated at our center.

A 37-year-old woman with intellectual disability presented with 1 day of obstipation, progressive abdominal distension, nausea, vomiting, and oral intake intolerance. Physical examination revealed a soft but distended abdomen without peritoneal signs. An abdominopelvic computed tomography (CT) scan showed marked dilation of the ascending and transverse colon with collapsed distal loops and a whirlpool sign at the splenic flexure, suggestive of distal transverse colon volvulus. Based on clinical and imaging findings, the patient underwent surgery, which confirmed the diagnosis.

This case report describes a young woman with intellectual disability who presented with large bowel obstruction symptoms, a profile consistent with a group considered at higher risk for transverse colon volvulus. Whirlpool sign, a transition zone, and dilated bowel loops in the abdominopelvic CT scan, which was emergently performed for the patient, supported the clinical diagnosis, which was crucial in the appropriate management of the patient.

While transverse colon volvulus is a rare condition, certain groups, such as individuals with intellectual disabilities, are at higher risk. Timely diagnosis and surgical treatment are key to a favorable outcome, and an abdominopelvic CT scan could be helpful in confirming the diagnosis.