Miftari Rrezane, Gazzetta Joshua
General Surgery, Saba University School of Medicine, The Bottom, BES.
General Surgery, Saint Luke's Hospital, Kansas City, USA.
Cureus. 2023 Jun 28;15(6):e41118. doi: 10.7759/cureus.41118. eCollection 2023 Jun.
Sigmoid volvulus can lead to life-threatening complications. We report a splenic capsule avulsion injury requiring laparotomy as a complication of sigmoid volvulus. A 73-year-old woman was admitted with abdominal distension, rigidity, and tenderness. CT abdomen revealed a splenic injury and hemoperitoneum along with possible sigmoid volvulus. The patient required an emergent exploratory laparotomy due to an acute abdomen and hemodynamic instability. A left colectomy, on-table sigmoidoscopy, hemostasis of the spleen, and temporary abdominal closure were performed. She required subsequent operations for end colostomy and abdominal closure. We establish that splenic lacerations are rare but life-threatening complications of sigmoid volvulus. Careful assessment of the spleen on abdominal imaging and clear visualization of the spleen during sigmoid volvulus surgery is recommended for early recognition and prompt management of splenic injury.
乙状结肠扭转可导致危及生命的并发症。我们报告一例乙状结肠扭转并发症，为脾包膜撕脱伤，需行剖腹手术。一名73岁女性因腹胀、腹壁紧张和压痛入院。腹部CT显示脾损伤、腹腔积血以及可能存在的乙状结肠扭转。由于急腹症和血流动力学不稳定，患者需要紧急进行剖腹探查术。进行了左半结肠切除术、术中乙状结肠镜检查、脾止血和临时腹壁关闭。她随后需要进行结肠造口术和腹壁关闭的后续手术。我们确定脾裂伤是乙状结肠扭转罕见但危及生命的并发症。建议在腹部影像学检查时仔细评估脾脏，并在乙状结肠扭转手术中清晰观察脾脏，以便早期识别和及时处理脾损伤。
