Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 1)

Transverse colon volvulus in neurologicaly imparied patient as an emergency surgical condition – A case report

Authors:
Maja Miličković, Djordje Savić, Nikola Stanković, Miroslav Vukadin, Aleksandar Vlahović, Dejana Božić

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Introduction. Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation and con-genital megacolon. Case report. We presented transverse colon volvulus in a 16-year-old boy with cerebral palsy. Chronic consti-pation in neurologicaly impaired patient was a risk factor predis-posing to volvulus. The patient was admitted to the hospital with enormous abdominal distension and acute respiratory insuffi-ciency. A boy was emergently taken to the operating room for exploratory laparotomy. During the surgery, a 360º clockwise vol-vulus of the transverse colon was found. After reduction of volvu-lus, an enormous transverse colon was resected and colostomy was formed. In the postoperative period, despite the good func-tioning of stoma and intraabdominal normotension, numerous and long lasting respiratory problems developed. The patient was discharged from our institution after 8 months. Conclusion. Though very rare in pediatric group, the possibility of a trans-verse colon volvulus must be considered in the differential diagno-sis of acute large bowel obstruction.