Pediatric Sigmoid Volvulus Presenting As Acute Intestinal Obstruction in a Previously Healthy 14-Year-Old Adolescent: A Case Report

TL;DR

A 14-year-old healthy girl experienced acute intestinal obstruction due to a rare condition called sigmoid volvulus, which was successfully treated with surgery.

Contribution

This case report highlights the importance of considering sigmoid volvulus in children with acute intestinal obstruction despite the absence of risk factors.

Findings

The patient presented with acute abdominal pain and distension, and imaging confirmed a sigmoid volvulus.

Emergency surgery successfully detorsed and resected the affected colon, preventing severe complications.

Abstract

Sigmoid volvulus is the torsion of the sigmoid colon around its mesenteric axis. It is a rare cause of intestinal obstruction in children and may be overlooked due to its nonspecific presentation. We describe the case of a previously healthy 14-year-old female who presented with acute abdominal pain, progressive distension, and prolonged obstipation, with imaging demonstrating a markedly dilated sigmoid colon and the characteristic “coffee-bean" sign consistent with sigmoid volvulus. She underwent emergency laparotomy, and intraoperative evaluation revealed a redundant, twisted sigmoid colon with preserved viability. She underwent successful detorsion, resection of the redundant sigmoid colon, and primary anastomosis. This case underscores the importance of maintaining a high index of suspicion for sigmoid volvulus in children presenting with acute intestinal obstruction, even in the absence of identifiable risk factors, as well as the need for prompt diagnosis using imaging and timely surgical intervention to prevent bowel ischemia and life-threatening complications.

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