Volvulus

Question 1

Volvulus is

Answer 1

due to intestinal segemental torsion that may lead to torsion and lead to obstruction or gangrene if untreated

Question 2

who gets sigmoid vovulus

Answer 2

commonly seen in elderly pts who are institutionalized or affected by neurological or psychiatric conditions (schizophrenia or Parkinson’s dx

Question 3

presentation of volvulus

Answer 3

abdominal pain, distention, constipation, and nausea See it on XR in 60% of time

Question 4

management of voluvulus

Answer 4

prevent gangrene and correcting underlying anatomical abnormality to reduce the risk of reoccurrence If no fever, sepsis or peritonitis, then can get sigmoidoscopy to untwist the volvulus and restore blood supply and assess colonic viability may leave a rectal tube to decompress area and prevent reoccurence

Question 5

if pt with volvulus gets sigmoidoscopy and see gangrene, next step

Answer 5

stop sigmoidoscopy and get surgery but can also get if there’s perforation or recurrent voluvulus despite conservative treatment.

Question 6

how many volvulus recurr?

Answer 6

can reoccur in hours to weeks and happen in 60% of them.

Question 7

Answer 7

volvulus and twisting of gut and cause torsion and gangrene

See distended proximal large bowel and airfluid levels in the small intestine.

Question 8

What is the abnormality

Answer 8

colonic volvulus. See dilated sigmoid colon (whirl pattern) around mesocolon and vessels creating a bird beak appearance.

Can see it better with barium enema with water solbule contrast if uncertain diagnosis.