Volvulus of the splenic flexure

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Abstract
This is the 1st case report of gangrenous colon from volvulus of the splenic flexure. It is also the 1st reported treatment of splenic flexure volvulus by exteriorization of the splenic flexure as a loop colostomy. Splenic flexure volvulus has been a rare cause of mechanical obstruction, producing 1% of colonic volvuluses. Fourteen detailed case reports of splenic flexure volvulus were reviewed. Patients averaged 53.2 yr old; 8 of 14 were women. Previous abdominal surgery, anomalies of fixation and constipation played important roles in the pathogenesis. Diagnosis was made before surgery in 2/3 of the patients. Treatment varied. One patient died without treatment. In 2, the volvulus reduced spontaneously. Eleven required emergency surgery. Three underwent operative detorsion, 1 exteriorization of the splenic flexure as a loop colostomy (the present report) and 6 partial colectomy. All treated patients survived without recurrence of volvulus. There was only 1 death in 14 cases, a 7% mortality rate. This low mortality rate was attributed to the rarity of gangrenous colon from splenic flexure volvulus.

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