Subacute Pediatric De Novo- Transverse Colonic Volvulus: A Rare Cause of Bowel Obstruction Case Report

Abstract

Introduction: Colonic volvulus represents 3-5% of all cases of bowel obstruction in adults, being the sigmoid colon the most common site and the transverse colonic volvulus the less common site. In the pediatric population, colonic volvulus is rare enough to not know it's true incidence. Presentation of Case:We present the case of a 16 year-old female with a history of chronic constipation and abdominal bloating that came to the emergency department with acute abdominal pain. Physical examination showed abdominal distension and pain in left mid-abdomen. A CT scan confirmed the presence of a transverse colonic volvulus. The patient was surgically intervened and a transverse colonic resection was done in a two-step procedure with an initially failed simple detorsion. A one-year follow up has been uneventful. Discussion: Because of the rare presentation of transverse volvulus in children, a consensus of the management of this entity has not been established. The surgical approach is based on the clinical scenario, the bowel's viability and the available resources. Conclusion:It seems that the most appropriate management is bowel resection with primary anastomosis when possible.