The posts on this blog are simply my medical study notes, my peripheral brain.
So I after I reviewed Dr. Fox’s excellent post on Sigmoid Volvulus, I reviewed two of my previous posts on pediatric abdominal pain:
- Pediatric Abdominal Emergencies Lecture From CHOP With Additional Resources
Posted on January 29, 2019 - Pediatric Acute Abdominal Pain
Posted on July 13, 2016
Dr. Fox of Pediatric EM Morsels, in his post Sigmoid Volvulus published January 25, 2019, reminds us that:
The threat of impending intestinal catastrophes is always lurking in the Pediatric ED [or office!]. It is contemplated with each patient with abdominal pain or vomiting.* While the symptoms may be related to non-emergent etiologies (ex, CRAP, Epiploic Appendagitis), our vigilant minds wrestle with concerns for Intussusception, Appendicitis, Malrotation, and Ogilvie’s Syndrome. Recently, we also discussed adding Cecal Volvulus to this list of considerations. Not wanting to offend the other end of the large intestine, we should also mention another possible cause of intestinal obstruction – Sigmoid Volvulus in Children.
* And we need to remember that vomitting can also occur in increased intracranial pressure and in diabetic ketoacidosis (especially when the patient has not yet been diagnosed with diabetes).
And Toxic Shock Syndrome can be mistaken for gastroenteritis, early on.