327 Rare Synchronous Volvulus of Sigmoid Colon and Caecum, Management of Two Cases

Abstract Colonic volvulus accounts for approximately 5% of cases large bowel obstruction. Sigmoid is commonest (75%), followed caecal (15%). Synchronous the caecum and sigmoid rare, with five reported in literature. We report two a London teaching hospital managed within 6 months. Both male patients (aged 72 79 years) had presented to emergency department on multiple occasions (2-5 times preceding 1-8 months), obstructive symptoms including tender abdominal distension constipation. On all occasions, was diagnosed based plain films flatus tubes were inserted, initial clinical resolution. their final presentation, both admitted definitive surgery. CT scans abdomen pelvis consistently as showing only volvulus. Only intra-operatively diagnosis synchronous appreciated. Complete symptom resolution achieved subtotal colectomy ileostomy formation. The key learning points from these are: 1) rare easily missed diagnosis, 2) conservative management unlikely be successful, 3) radiological appearances may suggest one type 4) made intra-operatively.