Volvulus

Question 1

Caecal volvulus (Caecal = Clockwise)

Answer 1

• Arises in the right lower quadrant.
• Extends towards the epigastrium or left upper quadrant
• Colonic haustral pattern is maintained
• Distal colon is usually collapsed and the small bowel is distended
• One air-fluid level may be seen
• Treat with right hemicolectomy

Question 2

Sigmoid volvulus

Answer 2

• Arises in the pelvis (left lower quadrant)
• Extends towards the right upper quadrant
• Ahaustral in appearance
• Sigmoid volvulus causes obstruction of the proximal large bowel, therefore the ascending, transverse and descending colon may appear dilated
• Few air-fluid levels may be seen
• Treat with Hartmann’s procedure