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Colonic Volvulus in Children: Surgical Management of a Challenging Condition.
- Source :
-
Children (Basel, Switzerland) [Children (Basel)] 2021 Oct 30; Vol. 8 (11). Date of Electronic Publication: 2021 Oct 30. - Publication Year :
- 2021
-
Abstract
- Colonic volvulus (CV) is a rare but potentially life-threatening condition with unclear etiopathogenesis. To date, less than 80 pediatric cases have been described. Hirschsprung's disease (HD) is associated with CV in 17% of cases, representing a significant risk factor. Non-HD CV is an even more complex entity. The aim of this study is to describe a series of patients with CV to accentuate some peculiar aspects of this disease. We performed a retrospective study (period: 2012-2021) collecting information of patients with CV. Data analyzed included: demographics, medical history, presenting symptoms and radiological and surgical details. Eleven patients (12.5 ± 2.8 years; 7F/4M) had CV (eight sigmoid, two transverse colon, one total colon). Five patients had associated anomalies and three had HD. A two-step approach with volvulus endoscopic/radiological detorsion followed by intestinal resection was attempted in eight cases (one endoscopic approach failed). Three patients required surgery at admission. At follow-up, two patients developed recurrent intestinal obstruction, one of whom also had anastomotic stenosis. Colonic volvulus is a challenging condition that requires prompt patient care. A missed diagnosis could lead to severe complications. The evaluation of the patient should include a careful histological examination (searching for HD and alpha-actin deficiency), immunologic and metabolic screening, neurological tests and detection of chronic intestinal pseudo-obstruction (CIPO). Lifelong follow-up is mandatory for the early recognition and treatment of progressive diseases involving the proximal gastrointestinal tract.
Details
- Language :
- English
- ISSN :
- 2227-9067
- Volume :
- 8
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Children (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 34828695
- Full Text :
- https://doi.org/10.3390/children8110982