Lee Eun-Kyung, Kim Ji Eun, Lee Yun-Young, Kim Saeyoon, Choi Kwang Hea
Department of Pediatrics, Yeungnam University Medical Center, Daegu, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2013 Jun;16(2):131-4. doi: 10.5223/pghn.2013.16.2.131. Epub 2013 Jun 30.
Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.
盲肠扭转在儿科患者中并不常见，关于盲肠扭转合并脑瘫的报道很少。在此，我们报告一例19岁男性患者，他表现为腹胀、脑瘫病史、因无脑回畸形导致的难治性癫痫以及慢性便秘。腹部X线和未增强的计算机断层扫描显示右下腹有固定扩张的肠管影像。尽管插入胃管和直肠管进行了减压，但症状并未改善。患者接受了剖腹探查术，结果显示为盲肠扭转。盲肠扭转通常发生在肠旋转不良或既往手术后。然而，在该患者中，智力残疾和慢性便秘伴随的肠扩张导致了盲肠扭转的发生。我们建议，对于出现进行性腹胀并伴有神经发育迟缓及便秘病史的患者，应考虑盲肠和近端大肠扭转的可能。
