Sigmoid volvulus

Case contributed by Dr Khalid Alhusseiny

Presentation

Continuous crying and progressive abdominal distention.

Patient Data

Age: 2 years
Gender: Female
X-ray

There is marked abdominal distention with diffuse gas distention of the bowel loops mainly involving the large bowel. The small bowel is mildly dilated.

The sigmoid colon (ahaustral loop) is dilated reaching about 14 cm in maximum diameter and occupies the abdominal and pelvic regions.

Barium

Water-soluble contrast enema was performed. The rectum is well opacified by the installed contrast. Resistance to contrast installation was noted with the arrest of the contrast at the level of rectosigmoid region.

Case Discussion

  • Sigmoid volvulus is a rare cause of pediatric bowel obstruction. The underlying etiology is usually a dilated redundant sigmoid with short mesentery.
  • The lack of colonic haustra can help in the differentiation between dilated sigmoid and dilated cecum.
  • This child was sent for surgery and a sigmoid volvulus was confirmed.

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Case information

rID: 76007
Published: 13th Apr 2020
Last edited: 13th Apr 2020
Inclusion in quiz mode: Included