Abstract

Splenic flexure volvulus is a rare clinical entity making up less than 2% of colonic volvulus cases. Due to the rarity of this condition the index of suspicion is low, making its prompt diagnosis and management unlikely. Splenic flexure volvulus may happen in children due to the absence or malformation of the ligaments that hold the splenic flexure in place. On the other hand, it may also occur in adults due to laxity of those ligaments, for example, secondary to previous abdominal surgery.

In most cases if patients are presenting acutely they will present with large bowel obstruction otherwise in the chronic setting they may present with chronic abdominal pain and chronic constipation. Here, we will present a splenic flexure volvulus case report about a middle-aged female who presented to the emergency department with acute abdominal pain, abdominal distention and vomiting. Computed Tomography (CT) renal without contrast was useful and illustrated the radiological signs of the splenic flexure volvulus. Urgent laparotomy was ultimately performed on the patient which revealed a gangrenous splenic flexure volvulus. It was resected with transverse end colostomy formation. Literature review is done in this case report taking into consideration the common etiologies, predisposing factors, clinical presentation, investigation and management of patients that presented with splenic flexure volvulus.

Keyword: Volvulus; Splenic Flexure

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