Volvulus of the Transverse Colon in a Severely Handicapped Infant With Trisomy 13: A Case Report

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Volvulus of the transverse colon is a very rare condition and patients often suffer from this condition with cerebral palsy and mental retardation. We report a case with volvulus of the transverse colon in a severely handicapped infant with trisomy 13. A 3-year-old boy was admitted to the social welfare corporation because of mental retardation. He usually used a laxative because of chronic constipation. He was referred to our hospital because of abdominal distention and bilious vomiting. He was then admitted to emergency surgery on diagnosis of a strangulated ileus. During the operation, volvuli of the transverse colon and mobile cecum were encountered. The necrotic colon was resected and end-to-end anastomosis was performed. The cecum and ascending colon were fixed to the retroperitonium to prevent recurrence of the volvulus. His postoperative course was uneventful and he was transferred back to the previous hospital on postoperative day 15. Twenty-four months later he had been asymptomatic. The treatment strategy of this disease is either an nonoperative approach, such as the use of barium enema and colonoscopy, or surgery. It is nescessary for us to resect and fix an elongated colon for recurrence prevention, and execute colostomy when the patients underlying disease is taken into consideration.
特定非営利活動法人日本小児外科学会の論文