- Volvulus of the transverse colon is a very rare entity, representing 1 to 3.4% of all volvuli of the colon. We report three cases illustrating the problems of this pathology. The presentation is usually acute, leading to prompt surgery. Multiple etiologies may be combined: congenital malrotations of the gut, chronic constipation in the elderly enhanced by psychiatric medications, and mechanical by adhesion bands which help to create anomalous rotation axes for the volvulus. The best treatment must be surgical, and we recommend an aggressive approach: an extended right colectomy, which gave good results in our patients.