Position of a sigmoid colon in right iliac fossa in children: A retrospective study

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Abstract

Aim:

The aim was to identify the position of sigmoid colon in children and discuss its clinical significance.

Materials and Methods:

Ninety-one contrast enema studies were retrospectively evaluated and the position of sigmoid colon categorized as below: Left lower quadrant, right lower quadrant, midline, and indeterminate.

Results:

The position of sigmoid colon in the right lower quadrant, left lower quadrant, midline, and indeterminate was 32 (35.16%), 33 (36.26%), 12 (13.19%), and 14 (15.38%), respectively. There was no statistically significant difference in mean age ( P = 0.87) or gender prevalence ( P = 0.49) for different positions of the sigmoid colon.

Conclusion:

The sigmoid colon occupies the right lower quadrant in a large number of children. Awareness of this finding is of crucial importance in correct interpretation of abdominal radiographs in the emergency room.

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Most cited references 12

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Intestinal malrotation in children: a problem-solving approach to the upper gastrointestinal series.

Kimberly Applegate, James M. Anderson, Eugene Klatte (2015)

Intestinal malrotation, which is defined by a congenital abnormal position of the duodenojejunal junction, may lead to midgut volvulus, a potentially life-threatening complication. An evaluation for malrotation is part of every upper gastrointestinal (GI) tract examination in pediatric patients, particularly neonates and infants. Although the diagnosis of malrotation is often straightforward, the imaging features in approximately 15% of upper GI tract examinations are equivocal and lead to a false-positive or false-negative interpretation. The clinical manifestations and upper GI tract findings of malrotation in older children and adults are less specific than are those in younger patients, and for this reason diagnosis of the condition may be more difficult. Successful differentiation between a normal variant and malrotation requires the use of optimal techniques in acquiring and interpreting the upper GI series. Familiarity with the upper GI series appearance of both normal and abnormal anatomic variants allows the radiologist to increase both diagnostic accuracy and confidence in the diagnosis of malrotation. Copyright RSNA, 2006.

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Current radiological management of intussusception in children.

W Rohrschneider, J Tröger, Minoru Ko … (2007)

Intussusception is the most common abdominal emergency situation in infants and small children. There has been great progress in diagnostic and therapeutic management of intussusception. Ultrasound (US) has been shown to be the first-choice imaging technique in diagnosing intussusception for reasons of high accuracy, simultaneous exclusion of differential diagnoses, and disclosure of additional pathologies. Controversial opinions exist worldwide concerning the nonoperative treatment of intussusception in infants and children. Pneumatic reduction under fluoroscopic guidance and hydrostatic reduction under US monitoring are the preferred techniques. The aim should be a success rate of at least 90% in idiopathic intussusception. This review summarizes different types of intussusception and outlines diagnostic aspects as well as several treatment concepts.

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Radiographic patterns of intestinal malrotation in children.

Graham Taylor, R B Markowitz, S Kramer … (1996)

Intestinal malrotation is a major diagnostic challenge in children. Sometimes the prognostic significance of the findings from upper gastrointestinal tract examinations is unclear. In a series of 69 surgically proved cases, the authors studied the prevalence and clinical consequences of various radiographic patterns of malrotation and correlated surgical findings with the radiographic location of the duodenum and cecum. Seven patterns of duodenal malrotation were observed. Almost all children in the series had abnormalities of rotation or fixation of both the duodenum and colon, resulting in narrowing of the mesenteric base with potential for midgut volvulus. Of 69 patients, only one (1.4%) had an anatomically normal duodenum, and four (5.8%) had a surgically confirmed normal cecum fixed in the right lower quadrant. In the absence of a corkscrew or Z-shaped duodenum, patterns that usually indicate volvulus or obstructing Ladd bands, colon position had greater prognostic implication, especially when the cecum was situated in the right upper quadrant or left upper quadrant. These latter patterns were associated with the highest prevalence of volvulus.

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Author and article information

Journal

Journal ID (nlm-ta): J Indian Assoc Pediatr Surg

Journal ID (publisher-id): JIAPS

Title: Journal of Indian Association of Pediatric Surgeons

Publisher: Medknow Publications (India )

ISSN (Print): 0971-9261

ISSN (Electronic): 1998-3891

Publication date (Print): Jul-Sep 2011

Volume: 16

Issue: 3

Pages: 93-96

Affiliations

[1]Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India

[1 ]Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Author notes

Address for correspondence: Dr. Akshay Kumar Saxena, Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh - 160 012, India. E-mail: fatakshay@ 123456yahoo.com

Article

Publisher ID: JIAPS-16-93

DOI: 10.4103/0971-9261.83485

PMC ID: 3160061

PubMed ID: 21897567

SO-VID: b2ce20bc-dc91-4edb-a1d8-f634c523089d

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Position of a sigmoid colon in right iliac fossa in children: A retrospective study

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Abstract

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Most cited references 12

Intestinal malrotation in children: a problem-solving approach to the upper gastrointestinal series.

Current radiological management of intussusception in children.

Radiographic patterns of intestinal malrotation in children.

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