Gohsman Zach, Chan Albert, Davis Michael K
University of Florida, Gainesville, FL, USA.
Glob Pediatr Health. 2021 Jul 29;8:2333794X211033438. doi: 10.1177/2333794X211033438. eCollection 2021.
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.
乙状结肠扭转在老年人中是一种广为人知的现象，但在儿童中罕见。其推测机制包括一个冗长的乙状结肠袢围绕狭窄、细长的肠系膜旋转，随后发生血管闭塞。这种情况可以是间歇性的，也可能自行缓解，这使得诊断变得复杂。早期诊断对于预防包括坏死、穿孔和败血症在内的缺血性并发症至关重要。腹痛、腹胀和呕吐是最常见的症状表现，然而腹部压痛并不常见。结肠扩张是腹部X线片上最常见的表现。钡剂灌肠显示扭转结肠呈“鸟嘴”状，而且，大多数儿科病例通过钡剂灌肠复位成功。如果没有肠缺血或穿孔的证据，内镜复位已被提议作为乙状结肠扭转的一线治疗方法，尤其是在儿童中。我们报告了一例15岁男性患者，其乙状结肠扭转经内镜复位成功且无并发症。
