Author/Editor		Trotovšek, Blaž
Title		Zaprtost in znaki akutnega abdomna kot posledica tubularne duplikature transverzalnega kolona - prikaz primera
Translated title		Constipation and signs of acute abdomen caused by giant tubular duplicature of colon transversum - case report
Type		članek
Source		In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 13. mednarodni simpozij o urgentni medicini; 2006 jun 14-17; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2006
Volume		str. 121-5
Language		slo
Abstract		Introduction: Severe acute onset of pain in children is often caused by constipation. Pain, vomiting, abdominal distension, presence of an abdominal mass and even elevated body temperature are common findings in affected children. Diffuse tenderness and sometimes guarding arepresent. Anatomic variations are sometimes the cause of constipation.Tubular duplications of gastrointestinal tract are extremely rare but possible cause of constipation in children. Case report: A case of tubular colonic duplication arising in the transverse colon, producing acute onset of severe ischemic abdominal pain in 6-year-old girl is presented. In her past medical history only several periods of constipation were mentioned. On a day of admission she presented with a 6-hour history of spasmodic abdominal pain, anorexia, nausea, and 7 episodes of bilious vomiting. Her abdominal discomfort was severe and diffuse throughout the abdomen. Physical examination revealed a patient affected by pain in protective posture. Diffuse tenderness without guarding was present and no pathological formation was palpated. A plain X-ray of the abdomen revealed no specific pathology except some retained stool in dilated descending colon. After enema she evacuated stool and her abdominal discomfort has diminished. Approximately 5 hours after admission a sudden, severe onset of ischemic type of pain was observed. Surgical consultation was obtained and a large collection of gas in left lower abdominal quadrant was found on physical examination. An emergency plain X-ray of the abdomen was performed and enormously dilated blind ending colonic pouch was observed. The patient immediately underwent exploratory laparotomy. A gigantic, 24 cm long and 9 cm in diameter, ischemic T- shaped duplication was found. Resection of duplicature with small part of colon and a primary end-to-end anastomosis was performed. (Abstract truncated at 2000 characters)
Descriptors		ABDOMEN, ACUTE CONSTIPATION INTESTINAL OBSTRUCTION COLON CHILD