Cecal volvulus in children

A mobile cecum predisposing to a major complication of laparoscopic assisted ileostomy

Laparoscopic-assisted stoma creation is becoming a more popular procedure in the adult surgical population. Our institution has previously reported the use of the laparoscopic assisted colostomy (LAC) in children. In this paper, we describe an important complication in a 4-year-old patient, with trisomy 21, who underwent a laparoscopic-assisted loop ileostomy (LAI) and, subsequently, developed a volvulus of the cecum around the loop ileostomy. We suggest that when LAI is performed, cecal mobility should be carefully evaluated. In the absence of adequate cecal peritoneal attachments, an additional procedure to fix the cecum should be considered to prevent a potential volvulus around the stoma.

Cecal volvulus: a rare cause of bowel obstruction in a pediatric patient diagnosed pre-operatively by conventional imaging studies

Cecal volvulus is an acute surgical condition that is extremely rare in children, with a mortality rate of up to 40%. The clinical symptoms are often non-specific, and pediatric patients frequently have neurological deficits with associated communication difficulties, making the clinical diagnosis extremely challenging. Conventional radiographic imaging studies play a key role in the prospective diagnosis in children. We report a rare case of cecal volvulus in a 12-year-old boy who was diagnosed pre-operatively by abdominal radiographs and a contrast enema.

Caecal volvulus in a child: an unusual postoperative complication

A 2.5 year old dysmorphic child with severe gastro-oesophageal reflux was admitted for elective fundoplication. Three days postoperatively, she developed progressive signs of intestinal obstruction. The diagnosis of caecal volvulus was suggested on the plain radiographic appearance, confirmed at laparotomy and treated by right hemicolectomy. The predisposing factors, diagnosis and approach to surgical management are discussed.