Colonic Volvulus in Children: Surgical Management of a Challenging Condition

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 co...

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Autores principales:	Francesca Destro, Luciano Maestri, Milena Meroni, Alessandro Campari, Federica Pederiva, Sara Costanzo, Giulia Del Re, Margherita Roveri, Gianvincenzo Zuccotti, Valeria Calcaterra, Gloria Pelizzo
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	colonic volvulus children pediatric surgery management Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/251d2664443e410885aa1e9265963ebd
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spelling	oai:doaj.org-article:251d2664443e410885aa1e9265963ebd2021-11-25T17:14:10ZColonic Volvulus in Children: Surgical Management of a Challenging Condition10.3390/children81109822227-9067https://doaj.org/article/251d2664443e410885aa1e9265963ebd2021-10-01T00:00:00Zhttps://www.mdpi.com/2227-9067/8/11/982https://doaj.org/toc/2227-9067Colonic 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.Francesca DestroLuciano MaestriMilena MeroniAlessandro CampariFederica PederivaSara CostanzoGiulia Del ReMargherita RoveriGianvincenzo ZuccottiValeria CalcaterraGloria PelizzoMDPI AGarticlecolonic volvuluschildrenpediatric surgerymanagementPediatricsRJ1-570ENChildren, Vol 8, Iss 982, p 982 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	colonic volvulus children pediatric surgery management Pediatrics RJ1-570
spellingShingle	colonic volvulus children pediatric surgery management Pediatrics RJ1-570 Francesca Destro Luciano Maestri Milena Meroni Alessandro Campari Federica Pederiva Sara Costanzo Giulia Del Re Margherita Roveri Gianvincenzo Zuccotti Valeria Calcaterra Gloria Pelizzo Colonic Volvulus in Children: Surgical Management of a Challenging Condition
description	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.
format	article
author	Francesca Destro Luciano Maestri Milena Meroni Alessandro Campari Federica Pederiva Sara Costanzo Giulia Del Re Margherita Roveri Gianvincenzo Zuccotti Valeria Calcaterra Gloria Pelizzo
author_facet	Francesca Destro Luciano Maestri Milena Meroni Alessandro Campari Federica Pederiva Sara Costanzo Giulia Del Re Margherita Roveri Gianvincenzo Zuccotti Valeria Calcaterra Gloria Pelizzo
author_sort	Francesca Destro
title	Colonic Volvulus in Children: Surgical Management of a Challenging Condition
title_short	Colonic Volvulus in Children: Surgical Management of a Challenging Condition
title_full	Colonic Volvulus in Children: Surgical Management of a Challenging Condition
title_fullStr	Colonic Volvulus in Children: Surgical Management of a Challenging Condition
title_full_unstemmed	Colonic Volvulus in Children: Surgical Management of a Challenging Condition
title_sort	colonic volvulus in children: surgical management of a challenging condition
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/251d2664443e410885aa1e9265963ebd
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Colonic Volvulus in Children: Surgical Management of a Challenging Condition

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