QUIZ: No. 14, 19/04/2026

Answer: Splenic flexure volvulus

Scanogram shows a dilated twisted colonic loop, arising from the left upper quadrant and convexity towards the right lower quadrant. Descending colonic and rectal gas shadows are not seen. Clinically, dilated bowel loops are seen in the upper abdomen.

CT shows the “whirl sign,” which represents twisting of the mesenteric vessels and fat in the left upper quadrant. Transverse and proximal colon are dilated. Descending and sigmoid colon are collapsed.

Intraoperatively, splenic flexure was found twisted and transverse colon was dilated. Long and thin mesentry was seen, predisposing to volvulus. Resection anastomosis was performed.

Splenic flexure volvulus is a rare form of colonic volvulus involving twisting of the colon at the splenic flexure. This condition is uncommon compared to sigmoid or cecal volvulus but is clinically significant due to its high risk of complications and frequent need for urgent surgical intervention.