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Small bowel volvulus in children: its appearance on the barium enema examination
Insights
Diagnosing pediatric small bowel volvulus requires careful examination of barium enema X-rays. The distinctive "beak" sign on imaging indicates this serious condition, necessitating prompt surgical intervention.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Surgery
Background:
- Small bowel volvulus is a rare but critical surgical emergency in children.
- Early diagnosis is essential to prevent complications such as bowel ischemia and necrosis.
Observation:
- This report details two pediatric cases of small bowel volvulus diagnosed via barium enema.
- One case involved malrotation, while the other was linked to post-operative adhesions.
Findings:
- The key diagnostic radiographic finding in both cases was the "beak" sign.
- This sign represents the tapering of the barium column at the point of twisting in the small bowel.
Implications:
- The presence of a "beak" sign on barium enema is highly suggestive of small bowel volvulus in children.
- Immediate surgical intervention is indicated upon radiographic diagnosis to preserve bowel viability.
Abstract:
Two children with small bowel volvulus diagnosed on barium enema examination are reported. In one patient the volvulus was associated with malrotation and in the other patient there was a post-operative peritoneal adhesion. In both cases the diagnosis was based on "beaking" of the head of the barium column at the site of volvulus. Radiographic demonstration of a "beak" sign in the small bowel on barium enema examination should suggest a diagnosis of small bowel volvulus, and indicates the need for immediate surgery.