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Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon. It is a common cause of bowel obstruction [ 1 ] and constipation . It is common in Asia, India (7% of intestinal obstruction ) and especially South India because of the high fibre diet.
Cecal volvulus is slightly less common than sigmoid volvulus and is associated with symptoms of abdominal pain and small bowel obstruction. Volvulus can also occur in patients with Duchenne muscular dystrophy due to smooth muscle dysfunction. [citation needed] Gastric volvulus causes nausea, vomiting, and pain in the upper abdomen.
An ileosigmoid knot or compound volvulus is an uncommon cause of intestinal blockage. [1] The condition arises when ileum loops wrap around the bottom of a redundant sigmoid loop. [2] In some countries in Africa, Asia, and the Middle East, the ileosigmoid knot is a well-known ailment; this condition is uncommon in the West. [3]
Diverticulosis often occurs in the sigmoid colon in association with increased intraluminal pressure and focal weakness in the colonic wall. It is a common cause of hematochezia. Volvulus occurs when a portion of the bowel twists around its mesentery, which can lead to obstruction and infarction. Volvulus in the elderly commonly occurs in the ...
Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital. [1] [2] Causes of bowel obstruction include adhesions, hernias, volvulus, endometriosis, inflammatory bowel disease, appendicitis, tumors, diverticulitis, ischemic bowel, tuberculosis and intussusception.
The narrow mesentery predisposes some cases of malrotation to midgut volvulus, a twisting of the entire small bowel that can obstruct the mesenteric blood vessels leading to intestinal ischemia, necrosis, and death if not promptly treated. The fibrous Ladd's bands can constrict the duodenum, leading to intestinal obstruction.
Volvulus [24] Sigmoid colon volvulus: Abdominal pain (>2 days, distention, constipation) Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting Clinical (history and physical exam) Imaging (abdominal X-ray or CT) Sigmoid: Gastroenterology consultation (flexibile sigmoidoscopy) Cecal: General surgery consultation (right hemicolectomy)
Localized ahaustral distended colon can be seen on abdominal x-ray during obstruction or volvulus. Sigmoidal volvolus, more often seen in psychiatric and neurologically impaired patients (e.g. Parkinson's disease), shows lack of haustra on x-ray and points from the pelvis to the right upper quadrant just below the diaphragm.