Pediatric syndrome of the splenic flexure of the colon: A case report and literature review

ABSTRACT Introduction: Syndrome of the splenic flexure of the colon is caused by congenital splenic colon curvature with excessively high fixed points, a lengthy transverse colon, and a narrow splenic flexure angle. Clinical manifestations of this syndrome lack specificity. To date, the causes of the syndrome are poorly characterized. Syndrome of the splenic flexure of the colon usually occurs in elderly women, but it is extremely rare in children. Here we report a case of a child with syndrome of the splenic flexure of the colon. Presentation of case: A 14-year old female patient developed constipation and bloating two years ago and received conservative treatment at their local hospital. One week earlier, the patient again experienced abdominal pain, constipation, and abdominal distension. After failure in improving the symptoms, the patient was transferred to our hospital. Through the preoperative abdominal barium enema X-ray and CT scan, the patient was finally diagnosed with syndrome of the splenic flexure of the colon. A laparoscopy-assisted subtotal colectomy and anastomosis were subsequently performed. The resected specimens were ˜70 cm in length and ˜10 cm in diameter. Histopathology was performed on the surgically removed specimens.The patient is undergoing regular re-examinations and is recovering satisfactorily. Conclusion: For children with recurrent abdominal pain, bloating and constipation, a barium enema X-ray is recommended. Surgery is recommended if syndrome of the splenic flexure of the colon is considered. Highlights: