Sigmoid volvulus: an uncommon complication of Hirschsprung's disease

Ranjan, Abhishek; Jain, Vishesh; Sharma, Swati; Gupta, Devendra K.

doi:10.1136/bcr-2016-214693

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Some reports, however, have described children and adult patients including 67-year-old women with the chronic constipation being diagnosed with HD [46][47][48][49]. Moreover, acute intestinal obstruction, perforation and volvulus sometimes overlap with HD in children and adults [50][51][52]. Actually in the present study, 33 children and 4 adults were diagnosed with HD.…”

Section: Discussionmentioning

confidence: 53%

The evaluation of rectal mucosal punch biopsy in the diagnosis of Hirschsprung’s disease: a 30-year experience of 954 patients

et al. 2016

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Section: Discussionmentioning

confidence: 53%

The evaluation of rectal mucosal punch biopsy in the diagnosis of Hirschsprung’s disease: a 30-year experience of 954 patients

et al. 2016

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“…HD was diagnosed in 27.3% of the cases, a higher incidence than that recently reported by Atamanalp (0.2% of sigmoid volvulus cases) [16], but we should consider that the author practices in an area where CV is endemic (eastern Anatolia) and may show some differences from our series. Moreover, volvulus is a rare complication of HD, but the reported incidence of HD among children with volvulus is 18% [29]. That being said, we also had 18% of patients with elongated mesentery and no chronic history of constipation.…”

Section: Discussionmentioning

confidence: 90%

Colonic Volvulus in Children: Surgical Management of a Challenging Condition

et al. 2021

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Colonic volvulus (CV) is a rare but potentially life-threatening condition with unclear etiopathogenesis. To date, less than 80 pediatric cases have been described. Hirschsprung’s disease (HD) is associated with CV in 17% of cases, representing a significant risk factor. Non-HD CV is an even more complex entity. The aim of this study is to describe a series of patients with CV to accentuate some peculiar aspects of this disease. We performed a retrospective study (period: 2012–2021) collecting information of patients with CV. Data analyzed included: demographics, medical history, presenting symptoms and radiological and surgical details. Eleven patients (12.5 ± 2.8 years; 7F/4M) had CV (eight sigmoid, two transverse colon, one total colon). Five patients had associated anomalies and three had HD. A two-step approach with volvulus endoscopic/radiological detorsion followed by intestinal resection was attempted in eight cases (one endoscopic approach failed). Three patients required surgery at admission. At follow-up, two patients developed recurrent intestinal obstruction, one of whom also had anastomotic stenosis. Colonic volvulus is a challenging condition that requires prompt patient care. A missed diagnosis could lead to severe complications. The evaluation of the patient should include a careful histological examination (searching for HD and alpha-actin deficiency), immunologic and metabolic screening, neurological tests and detection of chronic intestinal pseudo-obstruction (CIPO). Lifelong follow-up is mandatory for the early recognition and treatment of progressive diseases involving the proximal gastrointestinal tract.

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“…Data from adult populations reveals a high success rate with colonoscopy or hydrostatic de-volvulus but there is a high recurrence rate, such that elective surgical resection of the sigmoid colon is often recommended for definitive treatment. 2 Data in children reveal a high coincidence (up to 16%) of Hirschsprung’s disease, 3 , 4 and may present in the newborn period 5 or later in life. 3 Rarely, there is an association with imperforate anus, roundworm infection, or Cornelia de Lange.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Reduction of Sigmoid Volvulus in a 15-Year-Old Male

Gohsman

Chan

Davis

2021

Global Pediatric Health

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Sigmoid volvulus is a well-recognized phenomenon in the elderly but rare in children. The proposed mechanism involves rotation of a redundant sigmoid loop around a narrow, elongated mesentery with subsequent vascular occlusion. The condition can be intermittent or may resolve spontaneously, complicating diagnosis. Early diagnosis is imperative to prevent ischemic complications including necrosis, perforation, and sepsis. Abdominal pain, abdominal distention, and vomiting are the most common presenting symptoms, however abdominal tenderness is uncommon. Colonic dilation is the most frequent finding on abdominal radiograph. Contrast enema reveals a “bird’s beak” configuration of the twisted colon and moreover, is successful in reducing the majority of pediatric cases. If there is no evidence of bowel ischemia or perforation, endoscopic reduction has been proposed as first-line treatment for sigmoid volvulus, especially in children. We report the case of 15-year-old male in which endoscopic reduction of sigmoid volvulus was successful without complication.

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Sigmoid volvulus: an uncommon complication of Hirschsprung's disease

Cited by 10 publications

References 9 publications

The evaluation of rectal mucosal punch biopsy in the diagnosis of Hirschsprung’s disease: a 30-year experience of 954 patients

The evaluation of rectal mucosal punch biopsy in the diagnosis of Hirschsprung’s disease: a 30-year experience of 954 patients

Colonic Volvulus in Children: Surgical Management of a Challenging Condition

Endoscopic Reduction of Sigmoid Volvulus in a 15-Year-Old Male

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