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Related Experiment Videos

Large bowel volvulus in childhood.

M Samuel1, S A Boddy, E Nicholls

  • 1Department of Paediatric Surgery, St George's Hospital, London, UK.

The Australian and New Zealand Journal of Surgery
|April 25, 2000
PubMed
Summary

Large bowel volvulus is rare in children but can be diagnosed with imaging and treated effectively with resection and anastomosis. This study details seven pediatric cases, highlighting clinical presentations and successful surgical outcomes without mortality.

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Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Colorectal Surgery

Background:

  • Large bowel volvulus is an exceptionally rare condition in pediatric patients.
  • The underlying causes, risk factors, and optimal management strategies for pediatric large bowel volvulus remain subjects of debate.

Purpose of the Study:

  • To report on seven consecutive cases of large bowel volvulus in children.
  • To analyze the clinical presentation, diagnostic methods, and treatment outcomes for pediatric large bowel volvulus.

Main Methods:

  • A retrospective review of seven pediatric cases of large bowel volvulus over a six-year period.
  • Diagnostic modalities included plain abdominal X-ray and barium enema.
  • Surgical intervention involved resection of the affected segment with primary anastomosis.

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Main Results:

  • The cases included cecal (n=2), transverse (n=1), and sigmoid (n=3) volvulus, with one patient experiencing transverse and subsequent sigmoid volvulus.
  • Common symptoms were abdominal distension, tenderness, constipation, and bloody mucoid rectal discharge.
  • All patients underwent successful resection and primary anastomosis, with no reported mortality during a mean follow-up of 3.4 years.

Conclusions:

  • Congenital anomalies such as abnormal ligamentous fixation, mesocolon abnormalities, or a common ileocolo-mesentery may predispose children to large bowel volvulus.
  • Large bowel volvulus should be considered in the differential diagnosis of pediatric constipation accompanied by bloody mucoid rectal discharge.
  • Resection and primary anastomosis represent the definitive surgical treatment for large bowel volvulus in children.