Work

A case report of a rare and challenging gangrenous splenic flexure volvulus in a pregnant patient

Year: 2018

Type: article

Abstract: INTRODUCTION: Splenic flexure volvulus is a rare cause of intestinal obstruction and is uncommonly encountered in young patients from developed countries. PRESENTATION OF CASE: This report details a challenging case of a gangrenous large bowel volvulus in a 25 year old woman 20 weeks pregnant, highlighting the diagnostic and operative challenges that this rare clinical situation presents. After urgent MRI confirming a splenic flexure volvulus, an emergency open left hemicolectomy and end colostomy was performed. Following uneventful recovery and successful delivery of her baby at full term, she was reversed 6 months later. DISCUSSION: Splenic flexure volvulus is a rare cause of large bowel obstruction, and as such can result in a delay in diagnosis, particularly in the setting of pregnancy. In this case, the patient was not diagnosed until day 3 of her admission when she decompensated with a rising white cell count. CONCLUSION: Splenic flexure volvulus is a rare occurrence. This case report of a young pregnant woman presenting with a large bowel obstruction due to splenic flexure volvulus highlights the importance of considering and investigating for this diagnosis.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2018.10.075

Authors: Alison Bullen, Joel Lewin, Trent Cross, Benjamin Woolven

Institutions: The University of Queensland, Cairns Hospital, James Cook University

Language: English

Topic: Intestinal Malrotation and Obstruction Disorders

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090