Volvulus of the Transverse Colon after Surgery for Esophagogastric Junction Cancer

We report a case of volvulus of the transverse colon after surgery for esophagogastric junction cancer. A 77-year-old woman visited our department because of dysphagia. The patient was given a diagnosis of esophagogastric junction cancer and underwent total gastrectomy and lower esophagectomy with antecolic Roux-en-Y reconstruction. The patient had cholecystitis on postoperative day 9, which was managed with conservative treatment. On postoperative day 34, the patient had abdominal pain, nausea, and vomiting accompanied by distension of the abdomen and abdominal tenderness. A massive bowel gas image was identified by abdominal radiography, along with disruption of the gas image on the left side of the transverse colon. Barium enema showed the bird beak sign around the splenic flexure. Abdominal CT scans showed that the transverse colon was bent and twisted around the jejunal limb mesentery. Transverse colon volvulus was diagnosed and she underwent another surgery on postoperative day 35. During the operation, the transverse colon was completely displaced to the right side of the jejunal limb, and it was rotated 270 degrees in a counter-clockwise manner from the residual omentum adhering to the jejunal limb mesentery, and further rotated 180 degrees from the jejunal limb mesentery.