volvulus

Question 1

define volvulus

Answer 1

torsion of the colon around its mesenteric axis resulting in compromised blood flow and closed loop obstruction

Question 2

what parts of the gut can be affected by volvulus?

Answer 2

o Sigmoid colon - 80%

o Caecum - 20%

Question 3

what are the associations of sigmoid volvulus?

Answer 3

• Older patients
• Chronic constipation
• Chagas disease
• Neurological conditions e.g. Parkinson’s disease, Duchenne muscular dystrophy
• Psychiatric conditions

Question 4

what are the associations with caecal volvulus?

Answer 4

• all ages
• adhesions
• pregnancy

Question 5

presenting symptoms of volvulus?

Answer 5

• Severe colicky abdominal pain and swelling
• Absolute constipation
• Abdominal bloating
• Vomiting

Question 6

signs of volvulus on physical examination?

Answer 6

• Signs of bowel obstruction
• Absent or tinkling bowel sounds
• Fever
• Tachycardia
• Signs of dehydration

Question 7

investigations for volvulus?

Answer 7

•	AXR 
o	Sigmoid volvulus 
-	Large bowel obstruction 
-	Coffee bean sign 
o	Caecal volvulus 
-	Small bowel obstruction