Splenic flexure colonic volvulus: a pediatric case report

Volvulus of the colon is an unusual cause of intestinal obstruction in the pediatric population. Splenic flexure colonic volvulus is the most uncommon site in children. We report a case of splenic flexure volvulus (SFV) in a 21-month-old boy with underlying cerebral palsy and epilepsy. He experienced abdominal distension, bilious vomiting and absence of bowel movement for 2 days. Abdominal radiography showed a proximal distended colon and a "coffee bean sign" at the left upper quadrant. Barium enema revealed a "bird beak sign" at the splenic flexure, which confirmed the diagnosis of SFV. Detorsion of SFV occurred while undergoing exploratory laparotomy. He received regular follow-up in the subsequent 3 years without recurrence.