Childhood sigmoid volvulus.

OBJECTIVES

Childhood sigmoid volvulus (SV) is a comparatively rare illness. The objective of this study was to examine the recent advances in childhood SV.

METHODOLOGY: In clinical review conducted at Ataturk University, Turkey, we used combined retrospective (from June 1966 to July 1986) and prospective (from July 1986 to July 2026) evaluation.

RESULTS

Fourteen children constituted 1.3% of total 1,101 SV cases. Mean age was 10.3 years (range: 10 weeks-17 years) and male/female ratio was 12/2 (85.7%/14.3%). Previous SV attack was present in two patients (14.3%). Mean admission period was 60.9 hours (range: 24-96 hours). Main clinical features were abdominal pain/tenderness (12 cases, 85.7%), distention (ten cases, 71.4%), abnormal bowel sound (nine cases, 64.3%), vomiting (seven cases, 50.0%), obstipation and muscular rigidity/rebound tenderness (six cases, 42.9% for each), hypokinetic/akinetic bowel sound and shock (four cases, 28.6% for each), and gangrenous stool (two cases, 14.3%). SV was diagnosed by abdominal X-ray radiography in seven patients (50.0%), at laparotomy in five cases (35.7%), and by computed tomography in two patients (14.3%). Emergency surgery was required in 12 cases (85.7%), while endoscopic detorsion was recently performed in two cases (14.3%) and elective surgery was added in one (7.1%). Mortality and morbidity were seen in four cases (28.6%) for each.

CONCLUSION

Although childhood SV is rare, it is still a critical area due to its relatively poor anamnestic inability, diagnostic difficulty, and prognostic outcome. However, diagnostic efficacy of CT, therapeutic contribution of endoscopic detorsion, and recurrence-preventive effect of elective laparoscopic surgery are important advances during the recent years.