Two unusual cases of megacolons

A 13-year-old boy with features of intestinal obstruction was found at laparotomy to have a sigmoid volvulus. A 7-year-old girl with a similar presentation had a tight stricture at the rectosigmoid junction causing obstruction. In both cases the proximal colon was grossly loaded with faeces. In the first child, a colostomy after resecting the sigmoid colon was considered the safer option, whereas in the second, an innovative method to decompress the proximal loaded colon using a sterilised colostomy bag was employed, enabling a primary anastomosis to be performed.