Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan.
J Pediatr Surg. 2011 Oct;46(10):E25-8. doi: 10.1016/j.jpedsurg.2011.06.019.
Primary splenic flexure volvulus is a rare entity. We describe the first case of splenic flexure volvulus managed by a laparoscopic approach. A previously healthy 32-month-old girl presented with constipation, appetite loss, and nonbilious vomiting of 15 days of duration. Contrast enema and 3-dimensional computed tomography revealed a "bird's beak" sign at the splenic flexure, consistent with the diagnosis of splenic flexure volvulus. Attempted detorsion during colonoscopy was unsuccessful, and a laparoscopic procedure was performed, and 180° torsion of the splenic flexure with a distal caliber change was observed. After detorsion of the volvulus, the splenic flexure and descending colon were fixed to the peritoneum. The postoperative course was uneventful, and there was no recurrence during the subsequent 16 months of follow-up. Laparoscopic colopexy is a minimally invasive and effective method of managing splenic flexure volvulus, especially in patients without an underlying disease that causes constipation.
原发性脾曲扭转是一种罕见的疾病。我们描述了首例通过腹腔镜治疗的脾曲扭转病例。一位 32 个月大的既往健康女孩因便秘、食欲减退和非胆汁性呕吐 15 天就诊。对比灌肠和 3 维计算机断层扫描显示脾曲呈“鸟嘴”征，符合脾曲扭转的诊断。结肠镜检查时尝试松解扭转失败，随后进行了腹腔镜手术，观察到脾曲扭转 180°，远端口径发生变化。扭转松解后，脾曲和降结肠被固定到腹膜上。术后过程顺利，在随后的 16 个月随访中没有复发。腹腔镜结肠固定术是一种微创且有效的治疗脾曲扭转的方法，特别是在没有导致便秘的基础疾病的患者中。
