Journal List > Korean J Pediatr Gastroenterol Nutr > v.13(2) > 1043472

Korean J Pediatr Gastroenterol Nutr. 2010 Sep;13(2):199-203. Korean.
Published online September 30, 2010.
Copyright © 2010 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
A Case of Sigmoid Volvulus in a Child
Dong Han Lee, B.A., Ju Hee We, M.D.,* Hyun Seok Park, M.D.,* Hae Young Kim, M.D., and Jae Hong Park, M.D.*
Postgraduate School of Medicine, Pusan National University, Busan, Korea.
*Department of Pediatrics, Pusan National University, Busan, Korea.
Department of Surgery, Pusan National University, Busan, Korea.

Corresponding author (Email: )
Received August 08, 2010; Revised August 12, 2010; Accepted September 06, 2010.


Sigmoid volvulus may cause acute or subacute colonic obstruction. Excessive length of the sigmoid colon may be a contributing factor. Typically, the patient develops bilious vomiting and marked gaseous abdominal distension. We report a case of sigmoid volvulus in a 9-year-old boy who presented with recurrent, sudden onset abdominal pain, abdominal distension, and vomiting for 1 year, which was diagnosed by simple abdominal X-ray, barium enema, computed tomography, and colonoscopic examination. Colonoscopic reduction failed and a sigmoid colectomy with primary repair was performed. The intra-operative findings showed that the sigmoid colon was noted to be dilated, and redundant with a lax mesentery. Two clear areas of compression (proximal and distal) were present. After sigmoidectomy, the symptoms resolved. After 5 years of follow-up, he had no new symptoms.

Keywords: Sigmoid volvulus; Child


Fig. 1
Simple abdominal radiograph reveals markedly dilated loops of the colon without rectal gas.
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Fig. 2
Barium study shows progressive tapered rectosigmoid tract (arrow) and dilated proximal sigmoid loop.
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Fig. 3
Abdominal computed tomography shows the 'whirl sign' (arrow) caused by torsion of the sigmoid mesentery.
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Fig. 4
Colonoscopy shows abnormal mucosal fold (A), luminal tapering from the rectosigmoid junction and counterclock-wise colon (B).
Click for larger image

Fig. 5
Photography shows markedly dilated and long sigmoid and abnormal mesocolon.
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