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Volvulus of the transverse and sigmoid colon

M Samuel1, S A Boddy, S Capps

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

Insights

Large-bowel volvulus (LBV) in children, often linked to congenital colon fixation issues, requires surgical resection and anastomosis for definitive treatment. This case highlights successful management in a pediatric patient with cerebral palsy.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Volvulus Pathophysiology

Background:

  • Large-bowel volvulus (LBV) is uncommon in children, often associated with underlying conditions.
  • Congenital anomalies in colonic fixation are implicated as a primary cause of LBV in pediatric populations.

Observation:

  • A 5-year-old male with cerebral palsy presented with symptoms of transverse and sigmoid colon volvulus.
  • The patient experienced significant gastrointestinal distress necessitating surgical intervention.

Findings:

  • Surgical resection of the affected transverse and sigmoid colon segments was performed.
  • Primary colocolic and colorectal anastomoses were successfully achieved, leading to an uneventful recovery.

Implications:

  • This case underscores that surgical resection and primary anastomosis represent the definitive treatment for pediatric LBV.
  • Understanding the role of congenital fixation defects is crucial for diagnosing and managing LBV in children.
  • Constipation may be a consequence rather than a cause of LBV in pediatric cases.

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