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Presentation and endoscopic management of sigmoid volvulus in children

机译:儿童乙状结肠扭转的表现及内镜处理

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摘要

The aim of the present study was to evaluate clinical presentation and management of sigmoid volvulus in children, focusing on endoscopic reduction. In this retrospective multicenter study, we reviewed the charts of 13 patients with sigmoid volvulus. We recorded clinical symptoms, diagnostic methods, endoscopic or surgical therapy, and outcome. The children (seven girls, six boys) had a median age of 12.8 years (range, 15 months to 17 years) at initial presentation. Eight patients had associated diseases (e.g., chronic constipation, mental retardation, or myopathy). The initial symptoms were abdominal pain (13/13), abdominal distension (11/13), and vomiting (7/13), which were associated with abdominal tenderness in all patients. Abdominal X-ray showed dilated sigmoid loops and air-fluid levels in all patients. Endoscopic reduction by exsufflation was successful without any complications in 12 patients, whereas the youngest patient underwent a first-line sigmoidectomy. Recurrence occurred in 7/12 patients after endoscopic exsufflation. Finally, 11 patients underwent a sigmoidectomy.
机译:本研究的目的是评估儿童乙状结肠扭转的临床表现和处理,重点是内镜下复位。在这项回顾性多中心研究中,我们回顾了13例乙状结肠扭转患者的病历。我们记录了临床症状,诊断方法,内窥镜或手术治疗以及结局。在初次就诊时,儿童(七个女孩,六个男孩)的中位年龄为12.8岁(范围为15个月至17岁)。八名患者患有相关疾病(例如慢性便秘,智力低下或肌病)。最初的症状是腹痛(13/13),腹胀(11/13)和呕吐(7/13),这些症状与所有患者的腹部压痛有关。腹部X线检查显示所有患者的乙状结肠环路和气液水平均升高。内窥镜消散术成功减少了12例患者的并发症,而最小的患者接受了一线乙状结肠切除术。内镜消融后复发的患者为7/12。最后,11例患者接受了乙状结肠切除术。

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