Mellor M F, Drake D G
Emergency Department, Children's Hospital of St. Paul, MN 55102.
AJR Am J Roentgenol. 1994 May;162(5):1157-9. doi: 10.2214/ajr.162.5.8166002.
Colonic volvulus is a rare type of intestinal obstruction in children. We reviewed our experience in 14 cases to determine the specific portion of the colon involved and the value of barium enema for diagnosis.
We retrospectively reviewed medical and radiologic records of 14 cases of colonic volvulus in children at the Children's Hospital of St. Paul from 1955 to 1992. Both abdominal plain radiographs and barium studies were examined. The children were 3 months to 15 years old.
Two cases involved the transverse colon, two were cecal, and 10 occurred in the sigmoid colon. Findings on barium enema indicated colonic volvulus in all 14 children. The barium enema also was successful therapy in 11 of the 14 cases.
As unusual as colonic volvulus is in children, it should remain in the differential diagnosis of abdominal pain of sudden onset in this age group. Fourteen cases were detected at our institution alone, two of which involved the transverse colon. The barium enema can be used to confirm the diagnosis and frequently is therapeutic.
结肠扭转是儿童肠梗阻的一种罕见类型。我们回顾了14例患儿的病例,以确定结肠受累的具体部位以及钡剂灌肠对诊断的价值。
我们回顾性分析了1955年至1992年在圣保罗儿童医院的14例儿童结肠扭转病例的医学和放射学记录。检查了腹部平片和钡剂造影。患儿年龄在3个月至15岁之间。
2例累及横结肠,2例为盲肠扭转,10例发生在乙状结肠。钡剂灌肠检查结果显示,所有14例患儿均为结肠扭转。14例中有11例钡剂灌肠治疗成功。
尽管结肠扭转在儿童中很罕见,但在该年龄组突发腹痛的鉴别诊断中仍应考虑。仅在我们机构就检测到14例,其中2例累及横结肠。钡剂灌肠可用于确诊,且常常具有治疗作用。