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Sigmoid volvulus in childhood.

S D Smith1, E S Golladay, C Wagner

  • 1Department of Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock 72202.

Southern Medical Journal
|July 1, 1990
PubMed
Summary
This summary is machine-generated.

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Sigmoid volvulus is rare in children but can be serious. Nonoperative decompression is effective for elective sigmoid resection, which is the definitive treatment to prevent mortality.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Sigmoid volvulus, though common in adults, is an infrequent pediatric condition.
  • This study investigates 48 pediatric cases of sigmoid volvulus, with a mean age of 8 years.

Observation:

  • Common symptoms include abdominal pain (66%) and vomiting (31%).
  • Abdominal distention (69%) was the most frequent finding.
  • The classic 'omega sign' was noted on plain films in only 29% of cases.

Findings:

  • Barium enema was diagnostic in 61% of pediatric sigmoid volvulus cases.
  • Nonoperative treatment (barium enema or proctoscopy) succeeded in 17 patients, but had a 31% recurrence rate.
  • Surgical 'derotation' alone had a 29% mortality, while immediate resection had a 25% mortality.

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Implications:

  • Elective sigmoid resection offers the best outcome, with no mortality in this series.
  • Nonoperative decompression is recommended for elective resection in patients without peritonitis.
  • Prompt diagnosis and appropriate management are crucial for improving outcomes in pediatric sigmoid volvulus.