Transverse colon volvulus: a case report of a 19-year-old patient with bowel obstruction

Bowel obstruction is a frequent reason for hospital admissions and can be categorized into small or large, partial or complete obstructions.While small bowel obstructions occur more often, large bowel obstructions account for 20%-25% of all cases, primarily aff ecting elderly patients. [1]Malignancy is the leading cause of large bowel obstruction and is responsible for 50%-60% of cases.Other causes include idiopathic, volvulus, infl ammatory, hernia, adhesion, intussusception, endometriosis, and functional colon disorders. [1]Colonic volvulus is the third most common cause of large bowel obstruction.Most cases of colonic volvulus occur in the sigmoid (60%-70%) and cecum (25%-40%) regions. [2]In contrast, transverse colon volvulus (TCV) is rare, accounting for less than 3% of large bowel obstructions. [3]This condition has a high mortality rate of 18%-33%, predominantly due to delayed diagnosis and the absence of characteristic radiological findings. [3][4][5] This case report presents a rare instance of TCV obstruction in a 19-year-old patient from Mankweng Academic Hospital.A 19-year-old African female presented with a threeday history of generalized abdominal pain, distension, vomiting, and scanty stools.The onset of symptoms occurred abruptly following the consumption of a burger and chips breakfast.She reported being awakened by severe abdominal distension and pain.The patient's medical history revealed a six-year duration of hemorrhoids, characterized by difficulties with stool passage.Notably, she had never utilized laxatives and did not experience stool passage problems during childhood.Additionally, two months earlier, she had undergone termination of pregnancy at nine weeks of gestation.Her medical history was otherwise unremarkable, with no previous surgical interventions.Upon physical examination, the patient exhibited signs of acute illness and severe pain.Her vital signs were within stable limits: blood pressure (112/82 mmHg [1 mmHg=0.133kPa]), pulse rate (91 beats/min), respiratory rate (15 breaths/min), temperature (36.6 C), and oxygen saturation (97% in room air).Abdominal examination revealed significant distension, predominantly in the right upper quadrant extending to the upper left quadrant,