Mittal Aditi, DeRoss Anthony, Goldman Deborah, Chen Charles B, Kay Marsha
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Children's, Cleveland, OH.
Department of Pediatric Surgery, Cleveland Clinic Children's, Cleveland, OH.
ACG Case Rep J. 2023 Mar 2;10(2):e00998. doi: 10.14309/crj.0000000000000998. eCollection 2023 Feb.
Acute colonic dilation in pediatric patients with ulcerative colitis (UC) raises a concern for toxic megacolon, but other rare conditions such as sigmoid volvulus may present in a similar manner. We report a rare case of a teenager with UC without prior surgery who developed an obstructing sigmoid volvulus managed with endoscopic detorsion and decompression. Colonic inflammation in patients with UC may result in a volvulus in the absence of other predisposing factors and should be considered in the differential diagnosis of patients with UC who present with obstructive symptoms with an atypical presentation.
溃疡性结肠炎(UC)患儿出现急性结肠扩张会引发中毒性巨结肠的担忧,但其他罕见情况如乙状结肠扭转也可能以类似方式表现。我们报告了一例罕见病例,一名未曾接受过手术的青少年溃疡性结肠炎患者发生了梗阻性乙状结肠扭转,通过内镜扭转复位和减压进行治疗。在没有其他易感因素的情况下,溃疡性结肠炎患者的结肠炎症可能导致扭转,对于出现梗阻症状且表现不典型的溃疡性结肠炎患者,鉴别诊断时应考虑到这一点。