Rare case of pediatric cecal volvulus

Abstract

An 11-year-old female child presented with abdominal pain, vomiting and constipation. An exploratory laparotomy revealed a cecal volvulus due to a congenital band and malfixation of the cecum. This was treated by excision of the band, derotation and decompression of cecum though an appendiceal stump suction.

A systematic review of the management and outcomes of cecal and appendiceal volvulus in children

“…The literature search revealed 76 papers, with 24 meeting the inclusion criteria, as detailed in Figure . All the papers included in this review were case reports, with a total of 29 patients, as detailed in Table . The median age was 10 ± 4.5 years, with a range of five days to 15 years, and the patients were predominantly male (72%).…”

“…Overall, a preoperative diagnosis of volvulus was made in nine children (31%) . In the other cases, interventions were indicated due to a clinical and radiological diagnosis of bowel obstruction in 18 cases , pneumoperitoneum in one and appendiceal abscess in another patient .…”

“…Given that early symptoms and physical findings of CV are nonspecific, radiography plays an important role in the management of AV. It might show markedly dilated bowel loops, with occasional air fluid levels and cecal distension, or one prominent segment of dilated bowel . Even when CV was not diagnosed, it showed evidence of bowel obstruction, which was enough to initiate management .…”

Volvulus of the appendix: a case report

“…Although there are many anomalies leading to intestinal rotation and fixation, these most often include acute and chronic midgut volvulus, acute and chronic duonenal obstruction secondary to bands, internal hernias, and cecal/sigmoid volvulus [1,2]. Volvulus of the appendix represents an uncommon phenomenon [3].…”

Volvulus of the vermiform appendix

“…It commonly occurs in sigmoid colon, malrotated midgut, caecum and stomach. 1 Though acute appendicitis and its consequence are common in all age group including childhood but volvulus of the appendix is an uncommon phenomenon in children. [2][3] Only a few reports exist in the medical literature concerning this subject.…”