Sigmoid volvulus in a teenager

Background: In pediatric surgical practice, volvulus of the sigmoid volvulus remains a rare cause of intestinal obstruction and this diagnosis is seldom considered in children. Case presentation: We present a 14-year old male who came with a 2-day history of abdominal pain, vomiting and abdominal distension. Plain abdominal x ray showed features of sigmoid volvulus (coffee bean sign). Non-operative decompression was not performed. He was optimized and had sigmoidectomy with primary anastomosis. The post-operative period was essentially uneventful except for the delayed resolution of the post-op paralytic ileus. He was discharged home on the 12th day post-operatively and is currently being followed up in the clinic. Conclusion: Sigmoid volvulus is an uncommon problem in children. A high index of suspicion is required to make a diagnosis because delays in diagnosis can be associated with morbidity and mortality.