Volvulus of the transverse colon after resection of the sigmoid volvulus: A case report

Sigmoid volvulus is a common cause of colon obstruction, while volvulus of the transverse colon rarely causes bowel obstruction. The occurrence of transverse colon volvulus after resection of the sigmoid colon volvulus is extremely rare. This report presents a 73-year-old man who presented with abdominal pain and peritonitis. The patient underwent exploratory laparotomy, and sigmoid volvulus and cecum perforation were confirmed. A right hemicolectomy, end-to-side ileotransverse colon anastomosis for the cecal perforation, and sigmoidectomy with end-colostomy (Hartmann's procedure) for the sigmoid volvulus were performed. A month later, the patient returned to the emergency room with abdominal distention and the blockage of colostomy. Abdominal CT revealed a transverse colon volvulus. A transverse and descending colon resection and ileorectal anastomosis were performed. The patient’s condition was stable at the time of discharge from the hospital. The management of metachronous colon volvulus should include surgical intervention. If patients are not diagnosed immediately, their condition may deteriorate dramatically because of bowel infarction or peritonitis. It is essential to highlight this case, as many surgeons may not have attended a transverse colon volvulus after sigmoid volvulus, which might lead to high morbidity or mortality. Overall, metachronous colonic volvulus must be considered in the differential diagnosis of bowel obstruction, particularly in patients with significant risk factors.