Volvulus

Volvulus
Volvulus
Classification and external resources

An xray of a person with a small bowel volvulus.
ICD-10 K56.2
ICD-9 537.3, 560.2
DiseasesDB 13996
eMedicine ped/2415
MeSH D045822

A volvulus is a bowel obstruction[1] with a loop of bowel whose nose has abnormally twisted on itself.[2]

Contents

Types

  • Volvulus Neonatorum.
  • Volvulus Small Intestine.
  • Volvulus Caecum.
  • Volvulus Sigmoid Colon (sigmoid volvulus).
  • Gastric volvulus.

Signs and symptoms

Regardless of cause, volvulus causes symptoms by two mechanisms.

  • One is bowel obstruction, manifested as abdominal distension and vomiting.
  • The other is ischemia (loss of blood flow) to the affected portion of intestine.

Volvulus causes severe pain and progressive injury to the intestinal wall, with accumulation of gas and fluid in the portion of the bowel obstructed.[2] Ultimately, this can result in necrosis of the affected intestinal wall, acidosis, and death. Acute volvulus therefore requires immediate surgical intervention to untwist the affected segment of bowel and possibly resect any unsalvageable portion.[2]

Volvulus occurs most frequently in middle-aged and elderly men.[2] Volvulus can also arise as a rare complication in persons with redundant colon, a normal anatomic variation resulting in extra colonic loops.[3]

Sigmoid volvulus is the most-common form of volvulus of the gastrointestinal tract[4] and is responsible for 8% of all intestinal obstructions.[citation needed] Sigmoid volvulus is particularly common in elderly persons and constipated patients. Patients experience abdominal pain, distension, and absolute constipation.

Associated conditions

The volvulus can also occur in patients with Duchenne muscular dystrophy due to the smooth muscle dysfunction.

Causes

Midgut volvulus occurs in patients (usually in infants) that are predisposed because of congenital intestinal malrotation. Segmental volvulus occurs in patients of any age, usually with a predisposition because of abnormal intestinal contents (e.g. meconium ileus) or adhesions. Volvulus of the cecum, transverse colon, or sigmoid colon occurs, usually in adults, with only minor predisposing factors such as redundant (excess, inadequately supported) intestinal tissue and constipation.

Diagnosis

Treatment

  • Untwisting by performing sigmoidoscopy and placing rectal tube, monitor for signs of bowel ischemia for 2-3 days, if no improvement, consult surgery for laparotomy (sigmoid resection and primary anastamosis)
  • Laparotomy
  • Transduodenal band of ladd is divided

See also

Gastric volvulus

References

  1. ^ "volvulus" at Dorland's Medical Dictionary
  2. ^ a b c d Wedding, Mary Ellen; Gylys, Barbara A. (2004). Medical Terminology Systems: A Body Systems Approach (Medical Terminology (W/CD & CD-ROM) (Davis)). Philadelphia, Pa: F. A. Davis Company. ISBN 0-8036-1249-4. 
  3. ^ Mayo Clinic Staff (2006-10-13). "Redundant colon: A health concern?". Ask a Digestive System Specialist. MayoClinic.com. Archived from the original on 2007-09-29. http://web.archive.org/web/20070929110621/http://www.mayoclinic.com/health/redundant-colon/AN00239/rss=1. Retrieved 2007-06-11. 
  4. ^ Turan M, Sen M, Karadayi K, et al. (January 2004). "Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process". Rev Esp Enferm Dig 96 (1): 32–5. PMID 14971995. http://www.grupoaran.com/mrmUpdate/lecturaPDFfromXML.asp?IdArt=456022&TO=RVN&Eng=1. 



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Look at other dictionaries:

  • Volvulus — est un mot latin pour indiquer le retournement d un tube sur lui même en faisant une boucle qui s étrangle à la base. Ce terme est utilisé en médecine appliqué au tube digestif[1] pour désigner certains cas d obstruction mécanique au transit… …   Wikipédia en Français

  • volvulus — [ vɔlvylys ] n. m. • 1685; lat. sc., de volvere « rouler » ♦ Méd. Torsion d un organe creux entraînant son obstruction. Volvulus gastrique, intestinal. Volvulus de la vésicule biliaire. ● volvulus nom masculin (latin volvere, rouler) Torsion d un …   Encyclopédie Universelle

  • volvulus — VÓLVULUS s.n. Ocluziune intestinală provocată de o răsucire a intestinului subţire sau a colonului pelvian, care are drept consecinţă tulburări grave ale circulaţiei, necroza peretelui intestinal etc. – Din volvulus. Trimis de ana zecheru,… …   Dicționar Român

  • Volvulus — Vol vu*lus, n. [NL., fr. L. volvere to turn about, to roll.] (Med.) (a) The spasmodic contraction of the intestines which causes colic. (b) Any twisting or displacement of the intestines causing obstruction; ileus. See {Ileus}. [1913 Webster] …   The Collaborative International Dictionary of English

  • Volvŭlus — Volvŭlus, so v.w. Darminvagination …   Pierer's Universal-Lexikon

  • Volvŭlus — (Darmverschlingung), s. Darmverschluß …   Meyers Großes Konversations-Lexikon

  • volvulus — 1670s, medical Latin, from L. volvere “to turn, twist” (see VULVA (Cf. vulva)) …   Etymology dictionary

  • VOLVULUS — VOLVULUS, см. Заворот кишок …   Большая медицинская энциклопедия

  • volvulus — vȍlvulus m DEFINICIJA pat. strangulacijski ileus koji nastaje ako se crijevna vijuga zaokrene oko svoje osnovice ETIMOLOGIJA lat.: zavrtaj, zaokret, torzija ← volvere: zakrenuti …   Hrvatski jezični portal

  • volvulus — [väl′vyo͞o ləs] n. [ModL < L volvere, to roll: see WALK] a twisting or displacement of the intestines resulting in intestinal obstruction …   English World dictionary

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