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From the Cecum to the Sigmoid: Twisted Colon in the Pediatric Population

Raphael H Parrado1, Nathan S Rubalcava2, Katherine P Davenport3

  • 1Division of Pediatric Surgery, Medical University of South Carolina, Charleston, USA.

Cureus
|October 18, 2021
PubMed

Insights

Colonic volvulus (CV) is rare in children but can cause severe obstruction. Prompt diagnosis and treatment are crucial for preventing complications in pediatric patients with colonic volvulus.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Colonic volvulus (CV) is a rare cause of intestinal obstruction in pediatric patients, differing significantly from adult presentations.
  • Understanding the unique pediatric CV etiology, clinical course, and management is essential for optimal patient outcomes.

Observation:

  • Two pediatric cases of colonic volvulus are presented, highlighting variations in presentation and management.
  • Case 1: A 12-year-old boy with sigmoid volvulus treated initially with endoscopic decompression, followed by recurrence and surgical intervention.
  • Case 2: A 17-year-old boy with cecal volvulus secondary to a congenital band, managed with emergent surgery.

Findings:

  • Pediatric colonic volvulus can manifest with diverse etiologies, including congenital abnormalities.
  • Diagnostic modalities like contrast enema and CT scans are vital for identifying CV and associated complications.
  • Treatment strategies range from endoscopic decompression to emergent surgical intervention, depending on the clinical scenario.

Implications:

  • Early recognition and prompt diagnosis of pediatric colonic volvulus are critical to minimize morbidity.
  • This condition necessitates a high index of suspicion in children presenting with abdominal pain and obstruction symptoms.
  • Tailored treatment approaches, considering both endoscopic and surgical options, are vital for effective management of pediatric CV.

Keywords:
abdominal paincecal volvuluscolonintestinal obstructionsigmoid volvulus

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