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FIGURE 116.12 Sigmoid volvulus. Abdominal radiograph shows a markedly distended
sigmoid colon (arrows ). (Reprinted with permission from Lee E. Pediatric Radiology:
Practical Imaging Evaluation of Infants and Children . Philadelphia, PA: Wolters Kluwer;
2017.)

Sigmoid Volvulus
Children with a history of severe chronic constipation or colonic dysmotility are
at risk of developing sigmoid volvulus due to dilatation of the sigmoid colon.
Symptoms may be insidious in onset but often progress to signs and symptoms of
complete bowel obstruction. Children with a history of colonic dysmotility who
present with acute severe abdominal pain, especially if vomiting or distension are
present, should have abdominal radiographs obtained in order to evaluate for
possible sigmoid volvulus ( Fig. 116.12 ).