Transverse Colon Volvulus in a Patient with Cerebral Palsy
作者
Chien-Chih Chen, Shung-Haur Yang, Jen-Kou Lin
卷期/出版年月
37卷6期 (2004/12)
頁次
266-269
摘要
A case of transverse colon volvulus is reported because of its rarity. This 22-yearold female was also a victim of cerebral palsy in bed-ridden status. She had a history of chronic constipation under laxative usage for many years. Acute-onset abdominal pain brought her to the emergency room. There was no stool passage for 5 days. Physical examination showed a severely distended abdomen with tenderness.
The muscle guarding sign was equivocal. A supine abdominal radiograph revealed enormously dilated colon loops. Emergent colonoscopy was attempted, and radiating ischemie mucosa folds were noted at the twisting point, 50 cm from
the anal verge. Colonoscopic decompression was abandoned and an emergent operation was performed. Transverse colon volvulus with strangulating gangrene was noted during the laparotomy. The whole colon was mobile without congenital fixation, from cecum to sigmoid colon. Subtotal colectomy with primary end-to-end ileocolostomy was performed. The patient recovered smoothly after the operation.