Sigmoid volvulus and ileosigmoid knotting in children

Six children with acute intestinal obstruction from sigmoid volvulus (SV) (n=2) and ileosigmoid knotting (ISK) (n=4) are reported. The median age at presentation was 4.5 years (range 2 weeks-15 years). Abdominal pain, distention, vomiting, and constipation were the main features. Two patients with ISK had bowel gangrene. In three children there was no identifiable cause; two had a narrow attachment of the sigmoid mesocolon with redundant colon and one had adhesive bands. Treatment was by resection and colostomy in five cases and derotation of the torted colon in one. One child with SV died following a wound infection. There was no recurrence. SV and ISK are uncommon in children. There are usually no features specific for these conditions, and the diagnosis is established at laparotomy. The prognosis is good when there is aggressive resuscitation and prompt surgery.