Surgery - Radiology - Pathology Rounds from The Montreal Children's Hospital: June 2024

Acute Presentations of Intestinal Conditions

This session discussed cases involving intestinal conditions, including colonic volvulus, bezoar obstruction, and trichotillomania, emphasizing the importance of early diagnosis and appropriate management.

Case 1. Cecal Volvulus

This is a case of a 16-y-old female patient with a history of epilepsy and a G2 dependency for feeding, who presented to the emergency department with progressive abdominal discomfort, dyspepsia, and constipation. The team considered the possibility of a colonic volvulus or an adhesive obstruction, and reviewed abdominal X-ray images and CT scan results to confirm the diagnosis. The team also discussed the potential obsolescence of certain exams because of advanced imaging techniques and shared experiences and pathology of rare cases of volvulus.

Case 2. Trichobezoar, Bowel Perforation

This case discussed the practice preferences regarding the use of CT scans in diagnosing appendicitis and other abdominal conditions in children. The discussion emphasized the increased risk of leukemia associated with single CT scans of the abdomen. The team then proceeded to review a case of a 3-y-old boy presenting with abdominal pain, vomiting, and constipation, who had been transferred from up north. The boy was found to have iron deficiency and a large, heterogeneous density in the epigastric area, prompting an upper GI study to identify the loops.


June 2024 S-R-P Patient Case Discussions

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