Volvulus Flashcards
1
Q
what is it?
A
axial rotation of gut
2
Q
risk factors?
A
- neurological disorders
- psychiatric disorders
- nursing home residents
- anything which alters position of intra-abdo contents ie chronic constipation, pregnancy
- adhesions
3
Q
types?
A
- volvulus neonatorum
- sigmoid
- caecal
- small bowel
4
Q
what is small bowel volvulus caused by?
A
post-op adhesions between anti-mesenteric border of small intestine & anterior abdo wall
5
Q
describe caecal volvulus
- what direction does it turn
A
occurs in Clockwise direction
- caecal –> clockwise
6
Q
diagnosis of caecal volvulus?
A
AXR, CT
7
Q
presentation of caecal volvulus?
A
symptoms of bowel obstruction & distension
8
Q
mx of caecal volvulus?
A
right hemi-colectomy +/- ileo-colic anastomosis
9
Q
what direction does sigmoid volvulus twist?
A
anti-clockwise
10
Q
clinical picture of sigmoid volvulus?
A
- sudden left-sided abdo pain
- distension
- absolute constipation
11
Q
diagnosis of sigmoid volvulus?
A
AXR: dilated colon, coffee bean sign
12
Q
Mx of sigmoid volvulus?
A
- emergency: endoscopic decompression
- subsequent sigmoid resection in fit pts
