Volvulus

Question 1

What is Volvulus?

Answer 1

Obstruction caused by a loop of the intestine that twists around itself and the mesentery.

Mesentery are tissues that connect the intestine to the back of the abdominal wall.

Question 2

What are the types of Volvulus?

Answer 2

• Sigmoid
• Cecal
• Midgut

Each type has distinct characteristics and risk factors.

Question 3

What is the most common type of Volvulus?

Answer 3

Sigmoid

Risks include pregnancy, age, constipation, Hirschprung disease, and abdominal adhesions.

Question 4

Which type of Volvulus is most common in young adults?

Answer 4

Cecal

Most commonly due to a mis-development of the abdominal mesentery.

Question 5

What type of Volvulus is common in babies and small children?

Answer 5

Midgut

Results from abnormal intestinal development in the fetus.

Question 6

What are the symptoms of Volvulus?

Answer 6

• Severe abdominal pain
• Abdominal distention
• Vomiting (with blood and bile)
• Nausea
• Constipation
• Blood/dark red stool
• Tachycardia and Tachypnea

Symptoms can vary in severity and may indicate complications.

Question 7

What is a complication of Volvulus and its symptoms?

Answer 7

• Infarction (death of intestinal wall)
• Peritonitis and Sepsis

Symptoms include bloating, constipation, severe pain, and bloody stool.

Question 8

What imaging techniques are used for diagnosing Volvulus?

Answer 8

• Abdominal X-RAY (bent inner tube/coffee bean)
• Barium enema (bird beak shape)

These images help visualize the obstruction.

Question 9

What are the signs of volvulus on AXR?

Answer 9

• Coffee bean sign
• Dilation of Proximal Large Bowel
• Bent Inner Tube Sign
• Loss of haustral pattern

Question 10

What is the treatment for Sigmoid Volvulus?

Answer 10

Sigmoidoscopy

This procedure is used to untwist the intestines.

Question 11

What is the treatment for Cecal Volvulus?

Answer 11

Colonoscopy

Used to untwist the intestines in Cecal Volvulus cases.

Question 12

What is the immediate surgical treatment for an acute patient with Volvulus?

Answer 12

Surgery if the bowel is severely twisted or blood supply is cut off.

Stable patients may be treated within 2 days after diagnosis.

Question 13

What procedure is performed for severe patients with infarction?

Answer 13

Bowel resection

This involves untwisting and attaching the intestine to the abdominal wall.

Question 14

Fill in the blank: The pathophysiology of Volvulus includes bowel twists forming a loop causing a _______.

Answer 14

bowel obstruction