Colonic volvulus in children: value of barium enema for diagnosis and treatment in 14 children.

Mellor, M. F. A.; Drake, D G

doi:10.2214/ajr.162.5.8166002

Cited by 51 publications

(47 citation statements)

References 3 publications

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“…Segment resection and end-to-end anastomosis are recommended in cases with viable intestines and a longer-than-normal mesocolon together with colonic fixation deficiency following detorsion. 5,12 However, our patient with transverse colon volvulus had an uneventful follow-up with a proper diet and treatment for constipation following detorsion despite the lack of colonic resection.…”

Section: Discussionmentioning

confidence: 79%

“…A success rate of 79% has been reported following a barium enema reduction, but recurrence is common and therefore, definite treatment of childhood colon volvulus is surgery. 12 Barium reduction provides some extra time to correct the patient's fluid-electrolyte balance and to treat dehydration before surgery. Our first case was operated on following preoperative preparation, because his physical examination revealed tenderness.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Colon Volvulus in Childhood: Case Report

Erdoğan¹,

Karaman²,

Çavuşoğlu³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T A 12-year-old boy with mental retardation and epilepsy was admitted with a 2-day history of vomiting, abdominal pain, constipation and severe abdominal distension. Physical examination showed a marked abdominal distention and generalized tenderness. Plain X-rays of the abdomen showed a markedly dilated loop of large intestine with multiple air-fluid levels. Surgical exploration revealed presence of a 180º counterclockwise volvulus of the transverse colon. A 15-year-old boy was admitted with the history of abdominal pain, constipation and abdominal distension. Non-operative reduction was performed with decompression of rectum and all the symptoms disappeared. The patient was discharged from the hospital. He was admitted with the same complaints seven days later. Surgical exploration revealed presence of a 720º counterclockwise sigmoid volvulus. Large intestinal volvulus is a rare surgical problem in childhood and it may be due to congenital or acquired anatomical variations. In this report, two cases of colon volvulus in childhood were presented and etiology and management were discussed. K Ke ey y W Wo or rd ds s: : Colon; child; intestinal volvulus; mental retardation Ö ÖZ ZE ET T Mental retardasyon ve epilepsili 12 yaşında bir erkek çocuk son iki gündür devam eden karın ağrısı, konstipasyon, şiddetli abdominal distansiyon ve kusma nedeniyle başvurdu. Fizik muayenede belirgin bir abdominal distansiyon ve yaygın hassasiyeti mevcuttu. Düz karın grafisinde çok sayıda hava-sıvı seviyeleri ile birlikte belirgin dilate kolon lupu gözlendi. Cerrahi eksplorasyonda kolonda saatin tersi yönünde 180°'lik transvers volvulusu olduğu görüldü. On beş yaşında bir erkek çocuk karın ağrısı, konstipasyon ve abdominal distansiyon ile başvurdu. Rektum dekompresyonu yoluyla sağlanan nonoperatif redüksiyon sonrası tüm semptomlar kaybolmuştu. Hasta hastaneden taburcu edildikten yedi gün sonra aynı yakınmalarla başvurdu. Cerrahi eksplorasyonda saatin tersi yönünde 720°'lik sigmoid volvulusu olduğu gözlendi. Kolon volvulusu çocukluk çağında nadir görülen bir cerrahi sorundur ve konjenital veya anatomik varyasyonlara bağlı olabilmektedir. Bu yazıda iki çocukluk çağı kolon volvulusu olgusu sunularak etyoloji ve tedavileri tartışılmıştır.A An na ah ht ta ar r K Ke el li im me el le er r: : Kolon; çocuk; bağırsak volvulusu; mental retardasyon T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 12 2; ;3 32 2( (4 4) ): :1 11 13 31 1--4 4

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Colon Volvulus in Childhood: Case Report

Erdoğan¹,

Karaman²,

Çavuşoğlu³

et al. 2012

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the possibility of perforation and risk of omitting bowel gangrene are the potential hazards. 2,9,11,12,17 Considering these risks, the techniques mentioned were limited for use, preferably only in children, in whom flexible endoscopy is more difficult and intussusception is more common.…”

Section: Discussionmentioning

confidence: 99%

Retraction

2009

J of Gastro and Hepatol

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Background and Aim: Sigmoid volvulus (SV) is an uncommon cause of mechanical intestinal obstruction. This study was designed to review the outcomes of 859 SV cases. Methods: The records of 859 patients were reviewed retrospectively. Results: The mean age of the patients was 58.1 years, and 83.0% of the patients were male. Of the patients, 25.9% had a history of volvulus episode, and 25.6% had associated disease. The mean symptom duration was 39.4 h, and 13.5% of the patients were in shock state. The most common symptoms and signs were abdominal pain and tenderness (98.7%), distention (96.0%), and obstipation (92.3%); and the correct diagnosis rate was 71.9% based on the clinical findings. Abdominal X-ray radiograph revealed SV findings in 65.0% of the patients. When used, computed tomography, magnetic resonance imaging and sigmoidoscopy were diagnostic in all patients. Conclusion: Sigmoid volvulus is generally seen in adult men, and it tends to recur. Associated diseases and shock are generally major problems in patients with SV. It presents in the form of large bowel obstruction, and a triad of colic abdominal pain, asymmetrical distention, and obstipation is valuable for diagnosis. Plain abdominal X-ray radiograph may help the diagnosis, while Computed tomography, magnetic resonance imaging and flexible endoscopy are more useful. The diagnosis of SV is established by clinical, radiological, endoscopic and sometimes operative findings.

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“…Presence of air in the bowel wall (pneumatosis intestinalis), free air in peritoneal cavity or in the portal vein would strongly indicate the presence of gangrenous gut. A barium enema with water soluble contrast is contraindicated when gangrene is suspected (Mellor MF 1994) . A CT scan would show the typical finding of a whirl sign at the site of the twist caused by dilated sigmoid colon around its mesocolon and vessels and bird beak appearance of the afferent and efferent colonic segment (Catalano O 1996).…”

Section: Investigationsmentioning

confidence: 99%

“…The management of sigmoid volvulus involves adequate and prompt fluid resuscitation, decompression of proximal bowel and urgent resection of the gangrenous segment (Asbun 1992, Bagarani 1993, Bhatnagar 2004, Oren 2007, Pahlman 1989, Ballantyne GH 1982, Kuzu MA 2002 . While in the absence mucosal ischemia it would seem reasonable to attempt detorsion and decompression via sigmoidoscopic placement of soft rectal tube or occasionally barium enema (Mellor MF 1994), the presence of gangrene of colon warrants immediate laparotomy after intensive resuscitation (Bhatnagar 2004, Ballantyne GH 1982, Kuzu MA 2002. In gangrenous sigmoid volvulus, resection and primary anastomosis may be performed with acceptable mortality and morbidity rates provided that the patients is haemodynamically stable and a tension free anastomosis of well vascularised segments of the bowel is feasible.…”

Section: Managementmentioning

confidence: 99%

Gangrene of Large Bowel Due to Volvulus-Etiopathogenesis, Management and Outcome

Machado¹

2011

Gangrene - Current Concepts and Management Options

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Colonic volvulus in children: value of barium enema for diagnosis and treatment in 14 children.

Cited by 51 publications

References 3 publications

Colon Volvulus in Childhood: Case Report

Colon Volvulus in Childhood: Case Report

Retraction

Gangrene of Large Bowel Due to Volvulus-Etiopathogenesis, Management and Outcome

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