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Sigmoid colon volvulus

From Wikipedia, the free encyclopedia
Medical condition
Sigmoid colon volvulus
Other namesSigmoid volvulus
SpecialtyGeneral surgery

Sigmoid colon volvulus, also known assigmoid volvulus, isvolvulus affecting thesigmoid colon. It is a common cause ofbowel obstruction[1] andconstipation. It is common in Asia, India (7% ofintestinal obstruction) and especially South India because of the highfibre diet. It is a very common cause of large bowel obstruction inPeru andBolivia due to high altitude.[2]

Signs and symptoms

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  • Pain in abdomen – initially left-sided, eventually all over
  • Absolute constipation
  • Enormousdistension of abdomen
  • Late vomiting and eventually dehydration
  • Features ofperitonitis
  • Hiccup and retching may occur
  • Tyre-like feel of theabdomen is diagnostic

Cause

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The condition is more common in males and with old age. It is also common in people with chronic constipation andlaxative abuse.

It is common in:[citation needed]

In sigmoid, volvulus rotation is always anticlockwise. It requires one and a half rotation to causevascular obstruction andgangrene which eventually leads to perforation either at the root or at the summit of the sigmoid loop.[citation needed]

Diagnosis

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  1. Plain X-ray (diagnostic in 70–80%): coffee bean sign is seen[3]
  2. Contrast enema: bird beak sign[citation needed]
  3. CT scan: shows characteristic whirl pattern[4]
  4. Blood:haematocrit, renal functions,serum electrolytes[citation needed]

Treatment

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References

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  1. ^Balachandar, M. (2017)."Emergency Resection and Primary Anastamosis (or Hartmann's) of Sigmoid Volvulus with Tube Caecostomy as a Temporary Decompression of Colon by Malecots Catheter"(PDF).New Indian Journal of Surgery.8 (1):47–48.doi:10.21088/nijs.0976.4747.8117.8.ISSN 0976-4747.
  2. ^Sriram Bhat (2012).SRB's Manual of Surgery. JP Medical Ltd. p. 997.ISBN 9789350259443.
  3. ^Jaypee Brothers (2007).Srb's Manual of Surgery by Bhat. Jaypee Brothers Publishers. p. 583.ISBN 9788180618475.
  4. ^Gingold D, Murrell Z (2012)."Management of Colonic Volvulus".Clin Colon Rectal Surg.25 (4):236–244.doi:10.1055/s-0032-1329535.PMC 3577612.PMID 24294126.
  5. ^Scott C Thornton (November 30, 2015)."Sigmoid and Cecal Volvulus".Medscape. RetrievedJune 13, 2016.

External links

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Classification
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