Salas S, Angel C A, Salas N, Murillo C, Swischuk L
Department of Radiology, The University of Texas Medical Branch, Galveston 77555, USA.
J Am Coll Surg. 2000 Jun;190(6):717-23. doi: 10.1016/s1072-7515(00)00270-2.
Sigmoid volvulus is an exceptionally rare and potentially life-threatening condition in the pediatric age group.
We report our experience with three children treated for sigmoid volvulus and review the cases reported in the medical literature since 1940.
Since 1940, 63 cases of sigmoid volvulus in children (including this series) have been reported. The median age was 7 years and the male to female ratio was 3.5:1. Two distinct presentations (acute and recurrent) were identified. Abdominal symptoms dominated the clinical picture. Barium enemas either confirmed or were highly suggestive of sigmoid volvulus. Reduction by barium enema was successful in 77% (10 of 13) of the attempts. Forty-nine patients underwent operative treatment, with sigmoidectomy (with or without primary anastomosis) being the most common. The overall mortality rate was 6%, operative mortality was 8.1%, and neonatal mortality was 14%. Associated conditions were frequent. Particular emphasis should be placed on ruling out Hirschsprung's disease (present in 11 of 63 patients).
Sigmoid volvulus remains a rare occurrence in children, but it should be included in the differential diagnosis of pain in children when colonic distention is present. An algorithm for treatment is proposed.
乙状结肠扭转在儿童年龄组中是一种极其罕见且可能危及生命的疾病。
我们报告了三例接受乙状结肠扭转治疗的儿童病例，并回顾了自1940年以来医学文献中报道的病例。
自1940年以来，已报道了63例儿童乙状结肠扭转病例（包括本系列病例）。中位年龄为7岁，男女比例为3.
