# Endoscopic and rectal tube management of pediatric sigmoid volvulus: A case series

## TL;DR

This case series describes the successful endoscopic and rectal tube management of three pediatric patients with rare sigmoid volvulus, preventing severe complications.

## Contribution

The paper presents a novel approach combining endoscopic detorsion and rectal decompression tube placement for initial stabilization in pediatric sigmoid volvulus.

## Key findings

- Endoscopic detorsion and rectal decompression tube placement effectively stabilized three pediatric patients with sigmoid volvulus.
- Two patients required subsequent surgical resection of redundant sigmoid colon after initial stabilization.
- The approach prevented complications like perforation, necrosis, or sepsis in the studied cases.

## Abstract

The process of the sigmoid colon twisting on its mesentery is known as sigmoid volvulus, a diagnosis rarely seen in the pediatric population. Volvulus can lead to blood flow obstruction of the colon and eventually perforation, necrosis, or sepsis. Predisposing factors include chronic constipation, chronic dysmotility, or Hirschsprung disease. This communication demonstrates three patients who presented to a tertiary pediatric care center with a diagnosis of sigmoid volvulus. All three patients underwent immediate endoscopic detorsion and rectal decompression tube placement. Two patients subsequently underwent surgical resection of redundant sigmoid colon. This communication highlights the use of sigmoidoscopy for detorsion of uncomplicated sigmoid volvulus with added support for initial rectal decompression tube placement, contributing to initial patient stabilization and positive patient outcomes.

Sigmoid volvulus is a rare pediatric diagnosis consisting of the sigmoid colon twisting on its mesentery.Immediate intervention of sigmoid volvulus is required to prevent bowel perforation, necrosis, or sepsis.Diagnostic imaging includes abdominal x‐ray or computed tomography.

Sigmoid volvulus is a rare pediatric diagnosis consisting of the sigmoid colon twisting on its mesentery.

Immediate intervention of sigmoid volvulus is required to prevent bowel perforation, necrosis, or sepsis.

Diagnostic imaging includes abdominal x‐ray or computed tomography.

Management of sigmoid volvulus may consist of immediate endoscopic detorsion with colonoscopy and subsequent surgical intervention, if no other contraindications such as bowel necrosis/gangrene, perforation, or peritonitis already present.There is added support for use of rectal decompression tube in the acute setting with endoscopic detorsion to prevent recurrence and contribute to initial patient stabilization.

Management of sigmoid volvulus may consist of immediate endoscopic detorsion with colonoscopy and subsequent surgical intervention, if no other contraindications such as bowel necrosis/gangrene, perforation, or peritonitis already present.

There is added support for use of rectal decompression tube in the acute setting with endoscopic detorsion to prevent recurrence and contribute to initial patient stabilization.