Volvulus of the transverse colon in children--Report of a case and review of the literature.

Abstract

Sigmoid, cecal and transverse colon volvulus have been responsible for approximately 3% of all large bowel obstruction in the United States. Transverse colon volvulus is much less frequent, occurring in less than 4% of all reported cases of colonic torsion. In the pediatric age group a review of the literature revealed seven cases only, to which we are able to add an eighth. Predisposing abnormalities implicated in the etiology of volvulus of the transverse colon include a redundant transverse colon, an elongated mesentery and close attachment or lack of fixation of the proximal and distal transverse colon. Chronic constipation and mental retardation are associated with this condition. The treatment is surgical intervention to untwist the volvulus and resect the redundant and often nonviable colon with primary colocolostomy or end-colostomy and mucous fistula as indicated.