Colonic volvulus in children with intestinal motility disorders. J Pediatr Gastroenterol Nutr 2009 Jul;49(1):59-62
Date
05/26/2009Pubmed ID
19465873DOI
10.1097/MPG.0b013e3181879eb5Scopus ID
2-s2.0-67651012620 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
BACKGROUND: Chronic intestinal pseudo-obstruction (CIP) is a condition characterized by symptoms of bowel obstruction in the absence of an anatomical cause. Patients with CIP and chronic intractable constipation (CIC) can also develop anatomical obstruction, and the presenting symptoms mimic those of underlying pseudo-obstruction.
OBJECTIVES: Our objectives were to evaluate the incidence, clinical presentation, and diagnostic investigations of colonic volvulus in children with intestinal motility disorders and to differentiate these episodes of colonic volvulus from the underlying motility disorder based on clinical presentation and imaging techniques.
MATERIALS AND METHODS: Patients records of children with colonic volvulus cared for at our institution over the previous 20 years were retrospectively reviewed. We identified 8 patients who were between 2 and 22 years of age at the time of diagnosis with colonic volvulus who also had CIP and CIC.
RESULTS: The mean age +/- SD at presentation with colonic volvulus was 13.2 +/- 5.05 years. All patients presented with worsening of abdominal distension and pain. The mean duration of symptoms of colonic volvulus before seeking medical help was 4.2 days (range 1-7 days). Water-soluble contrast enema was the single most useful investigation for confirming the diagnosis. All patients required surgery. There was no mortality associated with colonic volvulus.
CONCLUSIONS: Clinicians should be vigilant and include volvulus in the differential diagnosis of the acute onset of abdominal distension and pain in patients with CIP and CIC. Delay in diagnosis can result in bowel ischemia and perforation.
Author List
Altaf MA, Werlin SL, Sato TT, Rudolph CD, Sood MRMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Child
Child, Preschool
Colonic Diseases
Constipation
Diagnosis, Differential
Female
Gastrointestinal Diseases
Gastrointestinal Motility
Humans
Incidence
Intestinal Pseudo-Obstruction
Intestinal Volvulus
Male
Pain
Retrospective Studies
Young Adult
