Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Sigmoid Volvulus in a Child

소아에서 발생한 S상 결장 염전증 1예

  • Lee, Dong-Han (Postgraduate School of Medicine, Pusan National University) ;
  • We, Ju-Hee (Department of Pediatrics, Pusan National University) ;
  • Park, Hyun-Seok (Department of Pediatrics, Pusan National University) ;
  • Kim, Hae-Young (Department of Surgery, Pusan National University) ;
  • Park, Jae-Hong (Department of Pediatrics, Pusan National University)
  • 이동한 (부산대학교 의학전문대학원) ;
  • 위주희 (부산대학교 의학전문대학원, 소아과학교실) ;
  • 박현석 (부산대학교 의학전문대학원, 소아과학교실) ;
  • 김해영 (부산대학교 의학전문대학원 외과학교실) ;
  • 박재홍 (부산대학교 의학전문대학원, 소아과학교실)
  • Received : 2010.08.08
  • Accepted : 2010.09.06
  • Published : 2010.09.30
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Abstract

Sigmoid volvulus may cause acute or subacute colonic obstruction. Excessive length of the sigmoid colon may be a contributing factor. Typically, the patient develops bilious vomiting and marked gaseous abdominal distension. We report a case of sigmoid volvulus in a 9-year-old boy who presented with recurrent, sudden onset abdominal pain, abdominal distension, and vomiting for 1 year, which was diagnosed by simple abdominal X-ray, barium enema, computed tomography, and colonoscopic examination. Colonoscopic reduction failed and a sigmoid colectomy with primary repair was performed. The intra-operative findings showed that the sigmoid colon was noted to be dilated, and redundant with a lax mesentery. Two clear areas of compression (proximal and distal) were present. After sigmoidectomy, the symptoms resolved. After 5 years of follow-up, he had no new symptoms.

본 증례는 1년 전부터 갑작스럽게 복부팽만과 복통이 반복하다 내원 10일 전부터 심한 복통과 복부팽만, 구토가 발생하여 내원한 9세 남자 환자이다. 복부 X-선 촬영과 바륨 관장 등의 검사로 S상 결장 염전증을 진단하고 내시경적 염전 정복과 감압술 시도하였으나 실패하였다. 수술 시야에서 심하게 확장되고 비정상적으로 긴 S상 결장과 굵은 혈관이 포함된 결장간막이 관찰되었고 S상 결장의 원위부 및 근위부에서 좁아진 부위를 확인하여 이 부분을 포함한 S상 결장 절제술을 시행하였다. 이후 환자는 5년 동안의 추적관찰에서 증상의 재발이 없었다.

Keywords

References

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