Overall
Diagnosis
Treatment
Overall
Volvulus is a condition in which the bowel twists on itself. It is common in sigmoid colon, due to
– The Sigmoid mesocolon is larger than the the sigmoid colon
– It is the most moveable part of larger intestine.
Causing obstruction of material which flow through the bowel as well as blood flow which can result necrosis or tissue death in intestine.
Twisting of sigmoid colon around it mesocolon. When the twist is above 1 and half turn there is stoppage of venous drainage and after that arterial supply also stop.
CAUSES
- A birth defect called intestinal malrotation
- Occuring in adult due to heavy meal after prolong fasting
As when the heavy meal reaches the large intestine in form of stool and the huge bulk rapidly descend in the sigmoid colon and the twisting occurs.
- Chronic Constipation
- Pregnancy
- Abdominal adhesion that develop after surgery, injury
SYMPTOMS
- Pain in left liliac fossa
- Rapid asymmetrical distention over left lower abdomen
- As the diseases progresses within an hour, pain become intolerable
- The pt cannot pass flatus
- Incase of necrosis the peritoneum become rigid
- High rise of temperature
- Nausea
- Vomiting
- Constipation
- Shock
- Bloody stool
- Bile vomiting
- On palpation tyre like distention in abdomen with the apex directed towards the umbilicus
Diagnosis
INVESTIGATION
- X-Ray of abdomen
- CT scan
- Stool examination test
- CBC ( Complete Blood Count)
Treatment
- Introduction of flatus tube per rectum
- Colostomy or Ileostomy
- Laparotomy
