A previously healthy 35-year-old woman suffered from recurrent abdominal pain which had occurred once a week since the age of 23 years. Abdominal CT showed splenic flexure volvulus. Therapeutic colonoscopy was performed successfully, but the frequency of pain attacks remained at once a week. The attacks began after she started to work mainly in a standing position, and never happened while lying down. Therefore, we thought they were induced by forward sigmoid flexure due to gravity. Posture advice, including the knee–chest position and abdominal compression using colonic intraluminal pressure for the resolution of incomplete volvulus during pain attacks, was effective. The severity and frequency of the pain attacks decreased from once a week to once a month. This is the first report of splenic flexure volvulus in which posture advice was effective. Posture advice as a measure to resolve recurrent splenic flexure volvulus should be attempted before surgery.
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