Sigmoid volvulus in children: a case report

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Emergency Medicine

Background:

• Sigmoid volvulus is a common cause of large bowel obstruction in specific geographic regions but is rare in children.
• It is often overlooked in pediatric patients, necessitating a high index of suspicion for timely diagnosis.

Observation:

• A 13-year-old girl presented with symptoms of intestinal obstruction.
• Radiography revealed the characteristic 'omega' or 'coffee bean' sign of sigmoid volvulus.
• Initial non-operative decompression via rectal tube and endoscopy was successful, but recurrence led to surgical sigmoidectomy.

Findings:

• Sigmoid volvulus is an uncommon but critical diagnosis in pediatric intestinal obstruction.
• Delayed diagnosis and treatment of pediatric sigmoid volvulus can significantly increase morbidity and mortality.
• Early detection and prompt intervention are crucial for a favorable prognosis.

Implications:

• Pediatric surgeons must consider sigmoid volvulus in the differential diagnosis of intestinal obstruction in children.
• Prompt management, whether non-operative or surgical, is essential for preventing severe complications.
• This case highlights the importance of vigilance and timely intervention in pediatric cases of sigmoid volvulus.