Volvulus Flashcards

1
Q

What is volvulus?

A

Torsion of the colon around itself and the mesentery that it is attached to

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2
Q

What complication does volvulus lead to?

A

Closed loop bowel obstruction - a section of bowel is isolated by obstruction on either side

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3
Q

What are the two main types of volvulus?

A

Sigmoid volvulus - most common
Caecal volvulus

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4
Q

What are the risk factors for volvulus?

A

Neuropsychiatric disorders
Nursing home residents
Chronic constipation
High fibre diet
Pregnancy
Adhesions

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5
Q

What is the clinical presentation of volvulus?

A

Vomiting - bilious
Abdominal distention
Diffuse abdominal pain
Constipation
Lack of flatulence

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6
Q

What initial investigation is used in the diagnosis of volvulus?

A

Abdominal XR

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7
Q

What is seen on XR in volvulus?

A

Coffee bean sign in sigmoid volvulus

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8
Q

What is the gold standard investigation for diagnosis of volvulus?

A

Contrast CT scan

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9
Q

What is the management of volvulus?

A

Same as bowel obstruction:
- NBM
- NG tube
- IV fluids

Endoscopic decompression (sigmoid volvulus), using a flexible sigmoidoscope

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10
Q

What is the surgical management of volvulus?

A

Laparotomy
Hartmann’s procedure - removal of rectosigmoid colon and formation of colostomy
Ileocecal resection or right hemicolectomy for caecal volvulus

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