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2.1
Colonic Volvulus
Volvulus of the Colon

Presentation

CASE PRESENTATION We present a 26-year-old male patient who presented at our accident and emergency department with complete bowel obstruction of 3 days’ duration. [academic.oup.com]

A plan of management with the major aim to convert emergency situations into elective or urgent ones is presented with the expectation that the mortality rate can be improved. Related Topics Related Articles Loading Related Articles [insights.ovid.com]

Funding and Disclosures * Presented at the annual meeting of the New England Surgical Society, Worcester, October 5, 1946. [nejm.org]

The acute form presents in sixty percent of children [ 3 ]. [wjes.biomedcentral.com]

Respiratoric

  • Cough

    Symptoms of Cecal Volvulus More commonly seen in people ages 30 to 60, cecal volvulus may be caused by abdominal adhesions, severe coughing, or pregnancy. [colorectalsurgery.ucsf.edu]

    Hirschsprung’s disease (where the large intestine becomes inflamed and leads to constipation and obstruction) infections overexertion pelvic tumors pregnancy (especially in the third trimester) previous abdominal surgeries that caused adhesions violent coughing [healthline.com]

Gastrointestinal

  • Abdominal Pain

    She returned 3 weeks later due to sudden abdominal pain, distension, fecaloid vomiting, and dehydration of 2-day progression. [revistagastroenterologiamexico.org]

    The location of abdominal pain can provide information about what may be causing the pain. [en.wikipedia.org]

    Case Presentation A fifteen year old boy presented with a three day history of left sided abdominal pain, constipation and vomiting to the pediatricians. Over the preceding year he had several episodes of intermittent abdominal pain. [wjes.biomedcentral.com]

  • Acute Abdomen

    Merck Manual Professional Version. http://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/ileus. Accessed Sept. 18, 2015. [mayoclinic.org]

    […] abdominal pain [ edit ] Acute abdomen can be defined as severe, persistent abdominal pain of sudden onset that is likely to require surgical intervention to treat its cause. [en.wikipedia.org]

    CT of the abdomen and pelvis in stable patients is another option. [ncbi.nlm.nih.gov]

Workup

What laboratory workup is indicative of volvulus? Well, not a whole lot. Your chemistries may be normal. You may have an increased white blood cell count. [lecturio.com]

[…] complete blood count, urine pregnancy test followed with quantitative blood beta-hCG Imaging: transvaginal ultrasound If patient is unstable: IV fluid resuscitation, urgent obstetrics and gynecology consultation If patient is stable: continue diagnostic workup [en.wikipedia.org]

This occurs despite the feasibility of prudent use of abdominal x-rays and CT scans. 45 Patients will often go to surgery without a full workup and diagnosis is made in the operating room. 46 Nonsurgical treatment for cecal volvulus via endoscopy is generally [ncbi.nlm.nih.gov]

Treatment

Diagnosis and Treatment of Sigmoid Volvulus Prompt diagnosis and appropriate treatment of sigmoid volvulus generally lead to a successful outcome. [colorectalsurgery.ucsf.edu]

Very similar results were observed in unilateral cryptorchid men who had had no treatment (and were still cryptorchid at semen examination). [scienceopen.com]

In the absence of a randomized study, the type of surgical treatment remains controversial, although colonic resection with restoration of continuity is the standard treatment [ 4, 8, 44 ]. [em-consulte.com]

[…] volvulus needs prompt treatment and usually requires surgery. [medicalnewstoday.com]

Prognosis

Early resection seems to prevent the risks of necrosis and recurrence, and to have a good prognosis for survival. [scienceopen.com]

Objective: To describe the clinical presentation, type of surgical procedures performed, and to determine the prognosis of sigmoid volvulus. [scopemed.org]

[…] mesenteric vessels bird's beak sign : if rectal contrast has been administered 6 X-marks-the-spot sign : crossing loops of bowel at the site of the transition split wall sign : mesenteric fat seen indenting or invaginating the wall of the bowel Treatment and prognosis [radiopaedia.org]

The multidisciplinary strategy will therefore depend on the term of pregnancy and the fetal prognosis. [em-consulte.com]

However, in instances where a volvulus has lead to tissue death in the bowel, the prognosis may be poor. [medicalnewstoday.com]

Etiology

Definition / general Complete twisting of loop of bowel around its mesenteric base of attachment, causing obstruction and infarction Terminology Also called torsion (volvulus is a more specific term referring to gastrointestinal torsion) Etiology Potentially [pathologyoutlines.com]

Etiology There is a wide range of causes; some are geographically-specific 5 : chronic constipation and/or laxative abuse fiber-rich diet (especially in Africa) Chagas disease (especially in South America) Associations chronic neurological conditions [radiopaedia.org]

The pathogenesis and etiology of colonic volvulus. Seminars in Colon and Rectal Surgery 1999;10:129-38. [ Links ] 3. Lepage-Saucier M, Tang A, Billiard JS, et al. Small and large bowel volvulus: Clues to early recognition and complications. [scielo.isciii.es]

Etiology The etiology of colon volvulus is probably multifactorial. Some factors are common to all locations of volvulus, such as chronic constipation, high fiber diet, frequent use of laxatives, history of laparotomy and anatomic predisposition. [em-consulte.com]

It is a potentially fatal condition whose etiology has been recognized for centuries. It can occur at different points in the colon, in patients of all ages, and risk factors include a high-fiber diet. [ncbi.nlm.nih.gov]

Epidemiology

Journal Journal ID (nlm-ta): Pan Afr Med J Journal ID (iso-abbrev): Pan Afr Med J Journal ID (publisher-id): PAMJ Title: The Pan African Medical Journal Publisher: The African Field Epidemiology Network ISSN (Electronic): 1937-8688 Publication date (Electronic [scienceopen.com]

Epidemiology The incidence of colon volvulus varies in different regions of the world. [em-consulte.com]

The epidemiology, aetiology, diagnosis and management of transverse colon volvulus are discussed. It is important to highlight this case and those in the literature, as many surgeons may never have seen a single case of transverse colon volvulus. [wjes.biomedcentral.com]

Epidemiology Constipation is the most common chronic gastrointestinal disorder in adults. [en.wikipedia.org]

Pathophysiology

In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Sept. 10, 2015. Glancy DG. Intestinal obstruction. [mayoclinic.org]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management, Expert Consult Premium Edition - Enhanced Online Features (9 ed.). Elsevier Health Sciences. p. 384. ISBN 1437727670. [en.wikipedia.org]

Prevention

Resection prevents volvulus from recurring; untwisting the volvulus with the sigmoidoscope may not prevent recurrence. Cecal Volvulus Cecal volvulus is twisting of the cecum and ascending colon. [colorectalsurgery.ucsf.edu]

Both of these procedures have high success rates and generally prevent recurrence. [wexnermedical.osu.edu]

The child may also be given intravenous (IV) fluids to help prevent dehydration and antibiotics to prevent infection. [kidshealth.org]

See also [ edit ] Colonoscopy Notes [ edit ] ^ a b Hoff, G.; Grotmol, T.; Skovlund, E.; Bretthauer, M.; Norwegian Colorectal Cancer Prevention Study Group (2009). [en.wikipedia.org]

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