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Sigmoid volvulus in children: a case report.

R De Castro, E Casolari, J A Caal

    Zeitschrift Fur Kinderchirurgie : Organ Der Deutschen, Der Schweizerischen Und Der Osterreichischen Gesellschaft Fur Kinderchirurgie = Surgery in Infancy and Childhood
    |April 1, 1986
    PubMed
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    Sigmoid volvulus, a rare condition in children, can be caused by an elongated sigmoid colon. This case highlights a severe instance in a 9-year-old, involving a large, necrotic segment requiring surgical intervention.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Abdominal Imaging

    Background:

    • Sigmoid volvulus is uncommon in pediatric populations, often associated with anatomical abnormalities like dolichosigmoid (elongated sigmoid colon) or absent mesosigmoid.
    • Early diagnosis and surgical management are crucial due to the risk of bowel ischemia and necrosis.

    Observation:

    • A 9-year-old male presented with symptoms suggestive of acute abdomen.
    • Surgical exploration revealed a significantly large, necrotic segment of the sigmoid colon.
    • The volvulus involved three complete counterclockwise rotations of the proximal sigmoid on the distal segment.

    Findings:

    • The patient had a massive sigmoid volvulus with extensive necrosis, indicating a critical condition.
    • The anatomical predisposition, likely dolichosigmoid, contributed to the acute event.

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  • Surgical intervention was necessary to address the compromised bowel segment.

    • Implications:

    • This case underscores the importance of considering sigmoid volvulus in children presenting with obstructive abdominal symptoms.
    • Prompt surgical intervention is vital to prevent catastrophic complications such as perforation and sepsis.
    • Understanding predisposing factors like dolichosigmoid is key for risk assessment and potential preventative strategies in pediatric patients.