Atypical Sigmoid Volvulus in an Adolescent: A Case Report and Literature Review
Introduction Sigmoid volvulus is an underrecognized diagnosis with potentially fatal outcomes in adolescents; the current study aims to present an adolescent with mild symptoms but was found to have extensive ischemic sigmoid volvulus. Case presentation An 18-year-old male complained of three days of moderate colicky…
2025 2,249 reads 0 citations
Case Reports
Atypical Sigmoid Volvulus in an Adolescent: A Case Report and Literature Review
IntroductionSigmoid volvulus is an underrecognized diagnosis with potentially fatal outcomes in adolescents; the current study aims to present an adolescent with mild symptoms but was found to have extensive ischemic sigmoid volvulus.
Case presentationAn 18-year-old male complained of three days of moderate colicky abdominal pain, with decreased appetite and diarrhea. Physical examination revealed diffuse abdominal tenderness and exaggerated bowel sounds without abdominal distension. A contrast-enhanced computed tomography scan demonstrated evidence of twisting the sigmoid and a part of the left colon around each other but without signs of ischemia and perforation. Sigmoidoscopy showed volvulus with dusky ischemic mucosa. An immediate surgical intervention through Hartmann's procedure was performed. After three months of the operation, colostomy closure and colorectal re-anastomosis were performed.
Literature reviewIn a review of the literature, adolescents presented with symptoms of abdominal pain, swelling, vomiting, dehydration, and even shock in more severe cases. Despite the lack of data regarding the optimal long-term approach for sigmoid volvulus in adolescents, in a review of 63 cases, 77% of them received operative treatment, with sigmoidectomy being the predominant procedure. The total mortality rate was 6%, with an operative mortality rate of 8.1%.
ConclusionStrangulated sigmoid volvulus should be considered in adolescents with abdominal pain despite having diarrhea and no clinically evident abdominal distention. Hartman’s procedure may result in a good outcome.
Keywords Volvulus Teenager Management Strangulated sigmoid volvulus Hartman’s procedure All subjects
Barw Medical Journal. 2025;3(5):63–68