Abstract
The records of 19 patients with sigmoid colon volvulus (SCV) who were treated surgically in a 36.5-year-period were reviewed. Seven of them (37 %) had ileosigmoidal knotting (ISK). The age range was between 10 weeks and 17 years (mean 10 years), and 17 patients (90%) were male. In two cases (11%) there was previous SCV history. The mean symptom duration was 57 h (range 24–96), and three patients (16%) were in shock. The main symptoms were abdominal pain (90%), distention (79%), vomiting (74%), and obstipation (58%), and the main signs were abdominal tenderness (90%), distention (79%), absence of stool in the rectum and hypo- or akinetic bowel sounds (58%), muscular rigidity (53%), hyperkinetic bowel sounds (32%), and melanotic stool in the rectum (21%). The torsion was found in a clockwise direction in 47%, and the torsion degree was 360 in 42%. In four patients (21%) there was no gangrene (one with ISK), whereas in 15 (79%) sigmoid colon was gangrenous (six with ISK, in whom small bowel was also gangrenous). In nongangrenous cases, detorsion (11%) or sigmoidopexy (11%) was performed. In gangrenous cases, gangrenous sigmoid colon was resected, and Hartmann’s procedure (74%) or primary anastomosis (5%) was performed. In those with associated gangrene of the small bowel, resection and enteroenteric anastomosis were done. Four patients (21%) died, with the most common cause of death being toxic shock. In 11 patients, including five with SCV and six with ISK, no recurrence was seen in a mean 18-year follow-up period (range 8–39). As a result, preoperative resuscitation, prompt surgery, and postoperative support are important in emergent SCV in children.
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References
Akdemir D, Atamanalp SS, Polat M, Polat KY, Yıldırgan Mİ (1994) Treatment of sigmoid colon volvulus by resection and anastomosis in single seance. Turk J Dis Colon Rectum 4:21–25
Al-Kouder G, Nawaz A, Gerami C, Matta H, Jacobsz AW, Al-Salem AH (2002) Volvulus of the sigmoid colon in a child. Saudi Med J 23:594–596
Atamanalp SS, Polat KY, Balık AA, Yıldırgan Mİ, Gencer B, Ören D (1995) Ileosigmoidal knotting in children. Turk J Med Sci 24:73–74
Catalano O (1996) Computed tomographic appearance of sigmoid volvulus. Abdom Imaging 21:314–317
Chirdan LB, Ameh EA (2001) Sigmoid volvulus and ileosigmoidal knotting in children. Pediatr Surg Int 17:636–637
De Caluwe D, Kelleher J, Corbally MT (2001) Neonatal sigmoid volvulus: a complication of anal stenosis. J Pediatr Surg 36:1079–1081
Erdener A, Ulman I, Ozcan G, Genc K (1995) A case of sigmoid volvulus secondary to Hirschsprung’s disease. Pediatr Surg Int 10:409–410
Feldman D. (2000) The coffee bean sign. Radiology 216:178–179
Ismail A (1997) Recurrent colonic volvulus in children. J Pediatr Surg 32:1739–1742
Javors BR, Baker SR, Miller JA (1999) The northern exposure sign: a newly described finding in sigmoid volvulus. AJR Am J Roentgenol 173:571–574
Kuzu MA, Aslar AK, Soran A, Polat A, Topcu O, Hengirmen S (2002) Emergent resection for acute sigmoid volvulus: results of 106 consecutive cases. Dis Colon Rectum 45:1085–1090
Puneet, Khana R, Gangopadhyay AN, Shahoo SP, Khanna AK (2000) Sigmoid volvulus in childhood: report of six cases. Pediatr Surg Int 16:132–133
Salas S, Angel CA, Salas N, Murillo C, Swischuk L (2000) Sigmoid volvulus in children and adolescents. J Am Coll Surgeons 190:717–723
Yang YJ, Chang MH, Ni YH (2001) Sigmoid volvulus in children: report of two cases. J Formos Med Assoc 100:134–136
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Atamanalp, S.S., Yildirgan, M.İ., Başoğlu, M. et al. Sigmoid colon volvulus in children: review of 19 cases. Ped Surgery Int 20, 492–495 (2004). https://doi.org/10.1007/s00383-004-1222-7
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DOI: https://doi.org/10.1007/s00383-004-1222-7