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Cecal volvulus in children with mental disability.

Kohei Takada¹, Yoshinori Hamada, Masato Sato

¹Division of Pediatric Surgery, Kansai Medical University, Shinmachi 2-3-1, Hirakata City, 573-1191, Osaka, Japan. takadako@hirakata.kmu.ac.jp

Pediatric Surgery International

|July 27, 2007

Summary

Cecal volvulus, a rare condition, can occur in children with mental disabilities, often exacerbated by prior surgery. Pediatric surgeons should consider this diagnosis in cases of intestinal obstruction in this vulnerable population.

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Area of Science:

Pediatric Surgery
Gastroenterology
Medical Genetics

Background:

Cecal volvulus is a rare cause of intestinal obstruction in children.
Children with mental disabilities and prior abdominal surgery may be at increased risk.
Abnormal cecal mobility is a prerequisite for cecal volvulus development.

Observation:

Two cases of pediatric cecal volvulus are presented: one in a child with trisomy 18 and another with Cornelia de Lange syndrome.
Both patients had a history of abdominal surgery.
Symptoms included abdominal pain, vomiting, and progressive abdominal distention.

Findings:

Surgical intervention was required for both cases, involving detorsion and fixation of the cecum or colostomy.
Color Doppler ultrasonography identified ileocecal vascular twisting in one case.
The authors hypothesize that intestinal distention, mental disability, and prior surgery contribute to cecal volvulus.

Implications:

Pediatric surgeons must consider cecal volvulus in the differential diagnosis of intestinal obstruction in mentally disabled children.
Early recognition and surgical management are crucial for favorable outcomes.
This highlights the importance of recognizing specific risk factors in pediatric surgical patients.