Motsumi Mpapho Joseph, Tlhomelang Omphile
Department of Surgery, Faculty of Medicine University of Botswana, Botswana.
Department of Surgery, Princess Marina Hospital, Gaborone, Botswana.
J Surg Case Rep. 2018 Nov 13;2018(11):rjy295. doi: 10.1093/jscr/rjy295. eCollection 2018 Nov.
We present a 26-year-old male patient who presented with complete bowel obstruction and peritonitis. His abdominal X-rays showed grossly distended large bowels with air-fluid levels. A differential diagnosis of sigmoid volvulus was entertained and the patient was taken for an exploratory laparotomy. Intraoperatively, we found a sigmoid volvulus and a concurrent transverse colon volvulus. A subtotal colectomy and colostomy was performed. The histopathology results showed mucosal and submucosal congestion, chronic inflammation, and no malignancy or dysplasia. Synchronous volvulus of the sigmoid and transverse colon is an extremely rare. Management includes endoscopic derotation and decompression followed by semi-elective surgery in non-complicated cases. When endoscopic decompression has failed or there is suspicion of necrosis or perforation, surgery is mandatory.
我们报告一名26岁男性患者，其表现为完全性肠梗阻和腹膜炎。他的腹部X线片显示大肠明显扩张，伴有气液平面。考虑乙状结肠扭转的鉴别诊断，该患者接受了剖腹探查术。术中，我们发现乙状结肠扭转并同时存在横结肠扭转。进行了次全结肠切除术和结肠造口术。组织病理学结果显示黏膜和黏膜下充血、慢性炎症，无恶性肿瘤或发育异常。乙状结肠和横结肠同步扭转极为罕见。治疗包括内镜下复位和减压，在非复杂病例中随后进行半择期手术。当内镜减压失败或怀疑有坏死或穿孔时，手术是必需的。
