Caecal Volvulus in a Child: An Unusual Postoperative Complication

Abstract

A 2.5 year old dysmorphic child with severe gastro‐oesophageal reflux was admitted for elective fundoplication. Three days postoperatively, she developed progressive signs of intestinal obstruction. The diagnosis of caecal volvulus was suggested on the plain radiographic appearance, confirmed at laparotomy and treated by right hemicolectomy. The predisposing factors, diagnosis and approach to surgical management are discussed.

A systematic review of the management and outcomes of cecal and appendiceal volvulus in children

“…The literature search revealed 76 papers, with 24 meeting the inclusion criteria, as detailed in Figure . All the papers included in this review were case reports, with a total of 29 patients, as detailed in Table . The median age was 10 ± 4.5 years, with a range of five days to 15 years, and the patients were predominantly male (72%).…”

“…Overall, a preoperative diagnosis of volvulus was made in nine children (31%) . In the other cases, interventions were indicated due to a clinical and radiological diagnosis of bowel obstruction in 18 cases , pneumoperitoneum in one and appendiceal abscess in another patient .…”

“…Given that early symptoms and physical findings of CV are nonspecific, radiography plays an important role in the management of AV. It might show markedly dilated bowel loops, with occasional air fluid levels and cecal distension, or one prominent segment of dilated bowel . Even when CV was not diagnosed, it showed evidence of bowel obstruction, which was enough to initiate management .…”

Rare case of pediatric cecal volvulus

“…[ 12 ] or after fundoplication. [ 13 ] Although not very frequently, this is regularly reported in adults and detorsion with cecopexy or resection and an end-to-end anastomosis are the suggested treatment options. [ 14 ] The rarity of the condition frequently leads to diagnostic delays and complications.…”