Mesosigmoidoplastía: una técnica alternativa para el manejo de vólvulos de sigmoides en pacientes críticos Mesosigmoidoplasty: an alternative technique for sigmoid volvulus in critically ill patients
A 10-year-old boy who was previously well presented with sudden onset of intermittent severe abdominal pain, non-bilious vomiting and constipation. Abdominal examination was essentially normal. Abdominal radiographs showed a large dilated... more
A 10-year-old boy who was previously well presented with sudden onset of intermittent severe abdominal pain, non-bilious vomiting and constipation. Abdominal examination was essentially normal. Abdominal radiographs showed a large dilated loop of the colon with a few air-fluid levels on erect views (a) and supine views displayed a coffee-bean sign (b). Contrast enema was done to exclude other pathologies, which disclosed gradual narrowing of the sigmoid colon up to the level of obstruction, this is termed bird's beak sign (c). Radiological features were consistent with the diagnosis of sigmoid volvulus (SV). The patient was taken to theatre for sigmoidoscopy, which successfully de-rotated SV and elective date for surgery was prearranged. However, the patient presented recurrent symptoms 3 weeks later. Urgent laparotomy was performed and 360-degree rotation of sigmoid colon identified (d). The bowel was de-rotated and sigmoid resection with primary anastomosis was performed. There were no complications and the child was asymptomatic at one-month follow-up. Histology result of resected sigmoid colon was within normal limits.
