Colonic volvulus in children: value of barium enema for diagnosis and treatment in 14 children.

Abstract

Colonic volvulus is a rare type of intestinal obstruction in children. We reviewed our experience in 14 cases to determine the specific portion of the colon involved and the value of barium enema for diagnosis. We retrospectively reviewed medical and radiologic records of 14 cases of colonic volvulus in children at the Children's Hospital of St. Paul from 1955 to 1992. Both abdominal plain radiographs and barium studies were examined. The children were 3 months to 15 years old. Two cases involved the transverse colon, two were cecal, and 10 occurred in the sigmoid colon. Findings on barium enema indicated colonic volvulus in all 14 children. The barium enema also was successful therapy in 11 of the 14 cases. As unusual as colonic volvulus is in children, it should remain in the differential diagnosis of abdominal pain of sudden onset in this age group. Fourteen cases were detected at our institution alone, two of which involved the transverse colon. The barium enema can be used to confirm the diagnosis and frequently is therapeutic.