title: Synchronic volvulus of splenic flexure and caecum: a very rare cause of large bowel obstruction.
abstract: Colonic volvulus involving the caecum and splenic flexure of the colon is an extremely rare surgical entity and, as a result, it is rarely entertained as a differential diagnosis for large bowel obstruction. The most common site of volvulus is located at the sigmoid colon (75%) followed by caecum (22%). Rare sites of colonic volvulus include the transverse colon (about 2%) and splenic flexure (1-2%). Synchronous double colonic volvulus is very rare. The presentation of this condition can be similar to the signs and symptoms of large bowel obstruction. CT imaging of the abdomen can be diagnostic; however, the diagnosis is often missed due to the rarity of this condition--in such cases, it can only be made at laparotomy. Management of this condition should be expedited to prevent a fatal outcome. We present the case of a 56-year-old woman with synchronous volvulus of the caecum and splenic flexure of the colon.
authors.affiliation: Department of General Surgery, San Fernando Teaching Hospital, San Fernando, Trinidad and Tobago.
authors.forename: Shariful
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of General Surgery, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
authors.forename: Devin
authors.initials: D
authors.lastname: Hosein
authors.affiliation: University of the West Indies, St Augustine, Trinidad and Tobago.
authors.forename: Patrick
authors.initials: P
authors.lastname: Harnarayan
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago.
authors.forename: Vijay
authors.initials: V
authors.lastname: Naraynsingh
mesh_terms: D002429:Cecal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D044684:Colon, Transverse / Q000000981:diagnostic imaging* / Q000601:surgery; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed