Volvulus Flashcards

1
Q

what is volvulus?

A

torsion of the colon around its mesenteric axis resulting in compromised blood flow and closed loop obstruction

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2
Q

what is the most common type of volvulus?

A

sigmoid

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3
Q

what is a sigmoid volvulus?

A

large bowel obstruction caused by the sigmoid colon twisting on the sigmoid mesocolon

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4
Q

why is caecal volvulus less common than sigmoid volvulus?

A

for most people caecum is a retroperitoneal structure so not at risk of twisting

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5
Q

what are the assocaitions of caecal volvulus?

A
  • all ages
  • adhesions
  • pregnancy
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6
Q

what are the assocaitions of sigmoid volvulus?

A
  • older patients
  • chronic constipation
  • chagas disease
  • neurological conditions
  • psychiatric conditions
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7
Q

what are the features of volvulus?

A
  • constipation
  • abdominal pain
  • abdominal bloating
  • nausea/vomiting
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8
Q

what investigations are done in volvulus?

A

abdominal film

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9
Q

what is seen on x-ray in sigmoid volvulus?

A

large bowel obstruction
(large, dilated loop of colon, often with air-fluid levels)
coffee bean sign

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10
Q

what is seen on x-ray in caecal volvulus?

A

small bowel obstruction
(valvulae conniventes, mucosal folds, that cross the full width of the bowel)

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11
Q

what is the management of sigmoid volvulus?

A

rigid sigmoidscopy with rectal tube insertion

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12
Q

what is the management of caecal volvulus?

A

operative
right hemicolectomy is often needed

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