Entrance of Transverse Colon Volvulus into the Diaphragm Defect: A Case Report

Background: Colonic volvulus is an uncommon yet clinically important condition. It can occur in different locations; however, transverse colon and splenic flexure are rarely involved. We hereby present a 62-year-old man with a rare condition of herniation of transverse colon and splenic flexure within the chest cavity. Case presentation: A 62-year-old man was admitted to our center, a teaching hospital in Iran, complaining about three-day abdominal pain, anorexia, constipation, and abdominal distention. He was intellectually disabled and had a previous history of chronic constipation. The imaging studies showed the bowel loops herniated into the thoracic cavity. A laparotomy procedure was performed. The twisted transverse colon and splenic flexure were present in the left hemithorax. Total colectomy and ileostomy were performed and the diaphragmatic defect was repaired. Conclusion: This work aimed to raise attention to the rare condition of concurrent diaphragmatic hernia and colonic volvulus. The diaphragmatic hernia can be a life-threatening condition per se. If it is accompanied by intestinal volvulus in rare cases, it creates a pressing condition. More studies are required to explain the etiology of this potentially fatal condition.