Laparoscopic detorsion and colopexy for splenic flexure volvulus in an infant

Inoue, Mikihiro; Uchida, Keiichi; Otake, Kohei; Kawamoto, Aya; Okita, Yoshiki; Hiro, Junichiro; Ohi, Masaki; Kusunoki, Masato

doi:10.1016/j.jpedsurg.2011.06.019

Cited by 9 publications

(10 citation statements)

References 12 publications

(17 reference statements)

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“…Laparoscopic colopexy has been reported in humans and horses [3,5,11,24]. In the present study, we successfully performed laparoscopic colopexy in 8 dogs without intraoperative or immediate postoperative complications.…”

Section: Discussionmentioning

confidence: 58%

Laparoscopic Colopexy in Dogs

et al. 2013

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ABSTRACT. Colopexy was accomplished in eight healthy mixed-breed dogs by use of a 3-portal laparoscopic technique without major intraoperative and postoperative complications. A permanent adhesion between the colon and the abdominal wall was observed. Concentrations of acute-phase C-reactive protein (CRP) were measured in serum as a marker of systemic inflammation postoperatively, and no relevant increase in CRP concentrations was found.

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Section: Discussionmentioning

confidence: 58%

Laparoscopic Colopexy in Dogs

et al. 2013

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“…6,10-61 Sixty-three were pediatric patients (≤18 years old) (Table 2). 5,6,16,23,26,27,31,36,38,40,41,45,49,62-95 Overall, age was documented in 233 reports [mean ± SD (37.7 ± 23.8 years old)] range (6 days to 89 years old). In pediatric patients, the average age was 10.7 ± 5.5 years old, while in adults it was 48.0 ± 20.0 years old.…”

Section: Resultsmentioning

confidence: 99%

“…However, detorsion (with fixation, or with ileostomy, or with elective resection) have been described in children with variable recurrence rates. 27,31…”

Section: Discussionmentioning

confidence: 99%

Volvulus of the Transverse Colon

Huerta

Pickett

Mottershaw

et al. 2021

The American Surgeon™

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Background In the United States, the third leading cause of a large bowel obstruction (LBO) is colonic volvulus with torsion occurring most commonly in the sigmoid and the cecum. Transverse colonic volvulus (TCV) is exceedingly rare and specific involvement of the splenic flexure (SFV) is even less common. The present analysis was undertaken to interrogate current trends in presentation, management, and outcomes of TCV. Methods In the present report, the world literature was reviewed for the past 90 years (1932 to 2021). We conducted a systematic review to identify all cases of TCV following the PRISMA guidelines. Results We identified 317 cases of TCV. This included SFV (n = 75), TCV in pediatric patients (n = 63), TCV in pregnant patients (n = 8), and TCV associated with other pathology such as Chilaiditi’s syndrome (n = 11). Compared to sigmoid and cecal volvulus, TCV was rare (.94%). It affected slightly more women (54%) than men, commonly in their third decade of life (37.7 ± 23.8). The clinical presentation and diagnostic imaging were consistent with LBO. Compared to sigmoid volvulus, there was a limited role for conservative management and colonoscopic decompression was less effective. The most common operation was segmental resection (25%). Mortality was (20%) commonly because of cardiopulmonary complications and affected more women (63%). The average age of this cohort was 55.7±24.6 years old. Discussion Our review showed that TCV is an uncommon surgical entity. The diagnosis is likely to be made at laparotomy. Prompt recognition is paramount in preventing ischemia necrosis and perforation. Compared to sigmoid and cecal volvulus, the mortality for TCV remains high.

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“…Colopexy has been introduced as a less invasive option in high risk or elderly patients with a reasonable recurrence rate. Inoue et al used laparoscopic colopexy in an infant with primary SFV and claimed that laparoscopic colopexy to be the procedure of choice, particularly for low-recurrence risk cases without underlying constipation [ 16 ]. In our case, we did not used laparoscopic approach as we assumed we might encounter overt peritonitis which is out of our laparoscopic skills.…”

Section: Discussionmentioning

confidence: 99%

Splenic flexure volvulus, a rare etiology of colonic obstruction: Case report

Sharifi

Tafti

Keramati

et al. 2021

International Journal of Surgery Case Reports

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Introduction Splenic flexure volvulus (SFV) occurs as a result of twisting or torsion of a redundant colon around its mesentery. The SFV can be divided into primary and secondary types. Presentation of case An 82-year-old woman with a previous history of Parkinson's disease, diabetes mellitus and hypertension presented with a primary complaimt of obstipation and progressive abdominal pain. Abdomen was grossly distended and tympanic with generalized tenderness. The rectum was empty on digital rectal examination. Complete blood count showed leuckocytosis and neutrophlia. Plain abdominal X-rays showed distented cecum and ascending colon without any air in the gut distal to the splenic flexure. Regarding her unstable condition even aftre fluid resuscitation, she was transferred to the operating room. SFV was found and the standard left hemicolectomy was performed and bowel continiuity was established with primary anastomis of remained colonic ends. Postoperative period was uneventfull. Discussion The splenic flexure is strictly attached to the adjacent organs so its volvulus is rare. Most cases of adult SFV have an underlying disease associated with chronic constipation. Diagnosis of volvulus is suspected based on the history, clinical exam, and imaging. The initial and urgent treatment of SFV, if there are no signs of ischemia or perforation, may be conservative with endoscopic detorsion. Gangrenous bowel should not be detorted and should be resected with primary anastomosis or a diverting stoma. Conclusion SFV should be considered as a possible diagnosis of chronic constipation which might be diagnosed with plain abdominal Xray in non emergent condition. Special attention should be given to the medication history of the patient as the anticholinergic agents propagate normal pristaltis.

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Laparoscopic detorsion and colopexy for splenic flexure volvulus in an infant

Cited by 9 publications

References 12 publications

Laparoscopic Colopexy in Dogs

Laparoscopic Colopexy in Dogs

Volvulus of the Transverse Colon

Splenic flexure volvulus, a rare etiology of colonic obstruction: Case report

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