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Volvulus of the transverse colon in children--Report of a case and review of the literature.

Sigmoid, cecal and transverse colon volvulus have been responsible for approximately 3% of all large bowel obstruction in the United States. Transverse colon volvulus is much less frequent, occurring in less than 4% of all reported cases of colonic torsion. In the pediatric age group a review of the literature revealed seven cases only, to which we are able to add an eighth. Predisposing abnormalities implicated in the etiology of volvulus of the transverse colon include a redundant transverse colon, an elongated mesentery and close attachment or lack of fixation of the proximal and distal transverse colon. Chronic constipation and mental retardation are associated with this condition. The treatment is surgical intervention to untwist the volvulus and resect the redundant and often nonviable colon with primary colocolostomy or end-colostomy and mucous fistula as indicated.

Adolescent↗

Transverse colon in adult umbilical hernia.

The transverse colon may extend into an umbilical or other ventral hernia. An unusual configuration, extra anterior loops, outpouchings, narrowing, or nonmalignant-appearing obstruction in the involved segment of the colon should suggest possible herniation. Clinical or radiographic confirmation is easily accomplished. Five cases are presented to illustrate some of the deformities of the transverse colon due to involvement in an umbilical hernia.

Aged↗

Volvulus of the transverse colon.

Volvulus of the transverse colon is rare. Seven cases, 6 acute, are presented. Early diagnosis and prompt surgical management prevented complications. At laparatomy, extended right hemicolectomy or end colostomy and distal mucous fistula are the procedures of choice. Non-resection was associated with recurrence in three cases.

Adult↗

Volvulus of the transverse colon.

Volvulus of the transverse colon is a rare condition requiring early diagnosis and treatment. In the absence of ischaemic changes within the redundant bowel, success can be anticipated with conservative fixation procedures. A case is reported which was treated by reduction, decompression and parallel colopexy. Although this disease has been infrequently reported in the past there may well be an increasing incidence with the introduction of high fibre diets and the use of the colonoscope.

Adult↗