Left Colic Angle Volvulus Pressing the Spleen: A Case Report from the Yopougon University Hospital (Abidjan, Ivory Coast)
Abstract
Colonic volvulus is the torsion of the colon around its mesentery, which generally occurs at the level of the sigmoid colon and the caecum in 60 to 75% and 25 to 40% of cases, respectively. In contrast, volvulus of the splenic flexure is rare, occurring in only 1% of cases. We report a rare case of volvulus of the splenic flexure of the colon involving the spleen. The patient was a 54-year-old man with chronic constipation who had undergone a laparotomy for acute intestinal obstruction 11 years prior. The examination revealed an obstructive syndrome. Further investigation revealed a volvulus of the left colic flexure involving the spleen in its torsion, with necrosis of the splenic flexure but no perforation. We performed a high segmental colectomy with splenic loop and splenopexy. Splenic angle volvulus is a rare cause of colonic obstruction, and its location around the spleen makes it exceptional. Hence the importance of our study to improve its management.
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References
2. Perrot L, Fohlen A, Alves A, Lubrano J. Management of the colonic volvulus in 2016. J Visc Surg. 2016;153(3):183–92. https://doi.org/10.1016/j.jviscsurg.2016.03.006.
3. Ballantyre GH, volvulus of the splenic flexure: report of a case and review of the literature. Say colon rectum. 1981 Nov-Dec; 24(8):630-2.doi Online 07/21/2023 at 12:30 p.m.
4. Amirsina Sharifi, Seyed Mohsen Ahmadi Tafti, Mohammadreza Keramati, Alireza Kazemeini, Behnam Behboudi. Splenic flexure volvulus, a rare etiology of colonic obstruction: Case report, International Journal of Surgery Case Reports 86 (2021) 106128 https://doi.org/10.1016/j.ijscr.2021.106128
5. McGarity WC, Bobo WE, Haynes CD. Volvulus of the splenic flexure of the colon: report of two cases and literature review. Am Surg 1966;32:425-30.
6. Wolf BS, Gugliemo J. Case of volvulus of the splenic flexure. J Mt Sinai Hosp 1956;23:741-5
7. Gerbaud F, Jouvin I, Oberlin O, Valverde A. Volvulus of the left colic angle. doi: 10.1016/j.jchirv.2019.03.065
8. Daldoul S, Baccari A, Gadria S, Ben Tahar A, Ben Moussa M. Splenic torsion: a rare cause of acute abdominal syndrome. Ann. Fr. Med. Urgence (2015) 5:63-64. DOI 10.1007/s13341-014-0492-5
9. Steinberg R, Karmazyn B, Dlugy E, et al (2002) Clinical presentation of wandering spleen. J Pediatr Surg 37:E30
10. Hamidou D, Léra GA, Seynabou F, Nfally B, Ibrahima K, Mohamadou LG, et al. Chronic torsion of a wandering spleen in an adolescent: a case report. Pan African Medical Journal 2016; 24:15.
11. Khalid E, Fatimazahra B, Rachid L, Abdelaziz F, Mohammed L, Nadia B, et al. Acute abdomen due to torsion of an ectopic spleen: a case report. Pan African Medical Journal 2012; 11:62.
12. Omata J, Utsunomiya K, Kajiwara Y, Takahata R, Miyasaka N, Sugasawa H, et al. Acute gastric volvulus associated with wandering spleen in an adult treated laparoscopically after endoscopic reduction: A case report. Surgical Case Reports 2016; 2: 47
13. Germain M. Muanda, Israël M. Mwepu, Valentin T. Kazadi, Mputu Yamba JB, A wandering spleen torsion revealed by a subocclusive intestinal syndrome, Ann. Afr. Med., vol. 11, no. 4, Sept. 2018
14. Brian WCA Tian, Gabriel V, Fausto C. WSES consensus guidelines on the management of sigmoid volvulus, World Journal of Emergency Surgery, volume 18, Article No. 34 (2023)
15. Yapo P, Koffi GM, Doumbia M, Lebeau R, Assohoun KTH, Miesseu JBK. Volvulus of a traveling spleen in an adult: a case report from the Yopougon University Hospital (Abidjan, Ivory Coast) J. Afrr. Hepato. Gastroenterol. (2011) 5: 180-182
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