Sigmoid volvulus is a common cause of colon obstruction, while volvulus of the transverse colon rarely causes bowel obstruction. The occurrence of transverse colon volvulus after resection of the sigmoid colon volvulus is extremely rare. This report presents a 73-year-old man who presented with abdominal pain and peritonitis. The patient underwent exploratory laparotomy, and sigmoid volvulus and cecum perforation were confirmed. A right hemicolectomy, end-to-side ileotransverse colon anastomosis for the cecal perforation, and sigmoidectomy with end-colostomy (Hartmann\'s procedure) for the sigmoid volvulus were performed. A month later, the patient returned to the emergency room with abdominal distention and the blockage of colostomy. Abdominal CT revealed a transverse colon volvulus. A transverse and descending colon resection and ileorectal anastomosis were performed. The patient\'s condition was stable at the time of discharge from the hospital. The management of metachronous colon volvulus should include surgical intervention. If patients are not diagnosed immediately, their condition may deteriorate dramatically because of bowel infarction or peritonitis. It is essential to highlight this case, as many surgeons may not have attended a transverse colon volvulus after sigmoid volvulus, which might lead to high morbidity or mortality. Overall, metachronous colonic volvulus must be considered in the differential diagnosis of bowel obstruction, particularly in patients with significant risk factors.
الانفتال السيني هو سبب شائع لانسداد القولون، بينما نادرا ما يتسبب انفتال القولون المستعرض في انسداد الأمعاء. ومن النادر للغاية حدوث انفتال القولون المستعرض بعد استئصال انفتال القولون السيني. يقدم هذا التقرير رجلا يبلغ من العمر ٧٣ عاما يعاني من آلام البطن والتهاب الصفاق. خضع المريض لبضع البطن الاستكشافي وتم التأكد من التواء القولون السيني وانثقاب الأعور. وتم إجراء استئصال النصف الأيمن للقولون، ومفاغرة القولون اللفائفي العرضي من طرف إلى جانب الانثقاب الأعور، واستئصال السيني مع فغر نهاية القولون (إجراء هارتمان) للانفتال السيني. بعد شهر، عاد المريض إلى الطوارئ يشتكي من انتفاخ في البطن وانسداد في فغر القولون. وكشف التصوير المقطعي المحوسب للبطن عن انفتال القولون المستعرض. تم استئصال القولون المستعرض والنازل ومفاغرة اللفائفي المستقيم. وخرج المريض من المستشفى في حالة مستقرة. يجب أن تشمل إدارة انفتال القولون متغير الزمن التدخل الجراحي. إذا لم يتم تشخيص المرضى على الفور، فقد تدهور حالتهم بشكل كبير بسبب احتشاء الأمعاء أو التهاب الصفاق. ومن الضروري تسليط الضوء على هذه الحالة لأن الكثير من الجراحين ربما لم يعالجوا انفتال القولون المستعرض بعد الانفتال السيني، مما قد يؤدي إلى ارتفاع معدلات المراضة أو الوفاة. بشكل عام، يجب مراعاة الانفتال القولوني المتغير الزمن في التشخيص التفريقي لانسداد الأمعاء، خاصة في المرضى الذين يعانون من عوامل خطر كبيرة.

BACKGROUND: The Hartmann procedure is currently recognized as a common, safe, and feasible surgical procedure. However, its reversal rate is low, and the optimal timing for Hartmann reversal surgery is controversial.
METHODS: A 65-year-old man came to our hospital with a complaint of an intestinal fistula next to the stoma. The patient had undergone a Hartmann procedure 13 years prior. We performed colonoscopy, computed tomography, and other diagnostics before successfully reversing the stoma.
CONCLUSIONS: Although the optimal time for Hartmann procedure reversal is controversial, time may ultimately not be a factor in the success of reversal.

BACKGROUND: Laparoscopic reversal of Hartmann\'s procedure offers reduced morbidity compared with open surgery while improving reversal rates. However, it is one of the most technically challenging operations in minimally invasive colorectal surgery, with further < 20% of the reversal procedures being attempted laparoscopically. Complications related to late conversion to open surgery may suggest a selective use of the laparoscopic approach for Hartmann\'s reversal in a subgroup of patients: The aim of this study is to systematically investigate the literature to identify the ideal case for a laparoscopic approach.
METHODS: Data were extracted from a systematic review of the literature of Medline, Scopus, Web of Science, Embase, and the Cochrane Central Register of controlled trials. Subgroup analysis to identify suitable patients for laparoscopic surgery included age at surgery, body mass index, American Society of Anesthesiologists status, indication for the index Hartmann\'s procedure (HP), interval time to reversal from the index HP, conversion to open surgery, and temporary ileostomy rate.
RESULTS: A total of 862 patients were included, with 403 cases performed laparoscopically. Conversion to open surgery occurred in 65 patients (mean 16.1%). The indication for the HP showed a trend toward more benign patients included in the laparoscopic group, and the interval time between the index Hartmann\'s procedure and its reversal was significantly shorter in the laparoscopic group with a trend toward a higher rate of temporary ileostomy in patients undergoing an open procedure.
CONCLUSIONS: Patients\' selection can explain these differences, with more complex disease operated via an open approach. Nevertheless, future studies are needed to demonstrate an increasing number of reversals attempted laparoscopically in high-volume centers.

Ileosigmoid knotting refers to the wrapping of the ileum around the base of the sigmoid colon, or vice versa thus forming a knot. It is a rare cause of intestinal obstruction, more so in pregnancy. We herein report a case of a primigravid woman who presented with an acute abdomen at 13weeks of gestation. The patient underwent emergency surgery. Laparotomy showed ileosigmoid knotting with gangrenous loops of both small bowel and sigmoid colon. The gangrenous bowel was resected. Primary anastomosis of small bowel and a Hartman\'s procedure was performed.

BACKGROUND: Intestinal endometriosis is often an infrequently considered diagnosis in female of childbearing age by general surgeon. There is a delay in diagnosis because of constellation of symptoms and lack of specific diagnostic modalities. Patients suffer from intestinal endometriosis for many years before they are diagnosed. Often, such patients are labelled with irritable bowel syndrome. Intestinal endometriosis has a diagnostic time delay of 8-11 years due to its non-specific clinical features and multi-system involvement.
METHODS: Our patient was a 32 years old Caucasian female who was referred to us with features of intestinal obstruction. Despite repeated clinical assessments and use of different diagnostic modalities the diagnosis was still inconclusive even after 21 days of her first presentation to primary care physician. She had an exploratory laparotomy, sigmoid colectomy, and Hartmann\'s procedure with a temporary colostomy with us. Histopathology confirmed endometriosis and also showed melanosis coli. She was referred to the gynaecological team for review and follow up.
CONCLUSIONS: Intestinal endometriosis should be considered as a differential diagnosis in female patients of childbearing age group presenting with non-specific gastrointestinal signs and symptoms. Our patient manifested intestinal endometriosis and melanosis coli on histopathology suggesting symptoms of long duration.
CONCLUSIONS: Bowel endometriosis is a less considered and often ignored differential diagnosis in acute and chronic abdomen. This condition has considerable effect on patient\'s health both physically and psychologically.