Acute volvulus of the sigmoid colon is a well-defined emergency abdominal condition in adults. It has usually been considered to be a disease of the elderly, but recent reports emphasize that young and middle-aged adults are also susceptible. However, there are virtually no reports of acute sigmoid volvulus occurring in children. It is the purpose of this paper to report 2 cases, one in a 10-year-old boy and another in a 12-day-old male infant, and to briefly review the diagnosis and management of this serious condition.
In order to appreciate the problems involved in the diagnosis and management of acute sigmoid volvulus, it is necessary to understand the pathogenesis of the condition. The most important etiologic factor is a large, redundant sigmoid loop with a narrow mesenteric base of attachment. This redundant sigmoid may twist around its narrow point of attachment, and when the torsion is more than 180