Ann Ital Chir. 2022;93:443-446.
Sigmoid volvulus (SV) is a rare cause of intestinal obstruction in children. Its varied presentation and rapid progression engender a high risk of morbidity and mortality. We report two cases of SV in teenage boys. Patient 1 is 16 years old and patient 2 is 17. Both presented to our institution with recent-onset abdominal pain, constipation, and nausea and vomiting, and both had previous episodes of SV. Patient 1 had been surgically treated with manual derotation, and patient 2, who had redundant colon, had two past episodes of endoscopically-treated SV. Both patients were in poor condition and had distended but treatable abdomens, with no peritoneal signs. After computed tomography (CT) confirmation of the clinical impression of no ischemia or perforation, we decided to attempt detorsion of the SV and decompression of proximal dilated colon by flexible endoscopy, and planned for elective surgery shortly after the endoscopic procedure. Because sigmoid volvulus is so rare in children, operative and technical details of endoscopic management are gleaned from the larger adult experience. In patients without signs of complication, initial endoscopic reduction is the gold standard, and elective sigmoid resection with primary anastomosis is often required to prevent recurrence. KEY WORDS: Case report, Children, Endoscopy, Endoscopic treatment, Sigmoid volvulus, Volvulus.
乙状结肠扭转（SV）是儿童肠梗阻的罕见原因。其多变的表现和迅速进展导致发病率和死亡率高。我们报告了两名青少年 SV 患者。患者 1 为 16 岁，患者 2 为 17 岁。两人均因近期出现腹痛、便秘、恶心和呕吐就诊，且均有 SV 既往史。患者 1 曾接受过手动复位治疗，患者 2 结肠冗长，曾有两次内镜治疗的 SV 发作。两名患者病情均不佳，腹部膨胀但可治疗，无腹膜征象。CT 证实无缺血或穿孔的临床印象后，我们决定尝试通过软性内镜松解 SV 并对近端扩张的结肠进行减压，并在内镜手术后不久计划进行择期手术。由于儿童 SV 非常罕见，因此从更大的成人经验中获取内镜治疗的手术和技术细节。对于没有并发症迹象的患者，最初的内镜复位是金标准，通常需要进行乙状结肠切除术和一期吻合，以防止复发。关键词：病例报告，儿童，内镜，内镜治疗，乙状结肠扭转，扭转。
