Volvulus Flashcards
What is a volvulus
A loop in the intestine that causes bowel obstruction
What are the three main volvuli
Sigmoid volvulus, caecal volvulus and midgut volvulus
What is the most common
Sigmoid volvulus
Description of sigmoid volvulus
A volvulus in the sigmoid colon. It may occur during pregnancy as the fetus can cause displacement and twisting of the colon. It is more common in the middle aged/elderly
What is hirschsprung disease and how can it cause volvulus
A disease that causes severe diarrhoea and the stool acts as a pivot point for the volvulus (just as any normal constipation too)
Description of caecal volvulus
A volvulus in the caecum of the large intestive. It is more associated with young adults that did not develop a normal abdominal mesentery. This can be caused by pregnancy or constipation
Description of midgut volvulus
A volvulus in the midgut that occurs in babies and small children due to malrotation of the bowel.
What does a malrotation do
Causes the caecum and appendix to be in the upper right of the abdomen instead of lower right.
Symptoms
Bloating, constipation, pain (severe if infarcted) and bloody stools
Diagnosis
AXR (coffee bean appearance) and barium enema (bird beak appearance)
What methods can unwind a sigmoid and caecal volvulus only
Sigmoidoscopy and colonoscopy
What method is used for all
Surgery to unwind and potentially remove any infarcted tissue
