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Sigmoid colon volvulus

Medical condition From Wikipedia, the free encyclopedia

Sigmoid colon volvulus
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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. It is a very common cause of large bowel obstruction in Peru and Bolivia due to high altitude.[2]

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Signs and symptoms

  • Pain in abdomen – initially left-sided, eventually all over
  • Absolute constipation
  • Enormous distension of abdomen
  • Late vomiting and eventually dehydration
  • Features of peritonitis
  • Hiccup and retching may occur
  • Tyre-like feel of the abdomen is diagnostic

Cause

The condition is more common in males and with old age. It is also common in people with chronic constipation and laxative abuse.

It is common in:[citation needed]

In sigmoid, volvulus rotation is always anticlockwise. It requires one and a half rotation to cause vascular obstruction and gangrene which eventually leads to perforation either at the root or at the summit of the sigmoid loop.[citation needed]

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Diagnosis

  1. Plain X-ray (diagnostic in 70–80%): coffee bean sign is seen[3]
  2. Contrast enema: bird beak sign[citation needed]
  3. CT scan: shows characteristic whirl pattern[4]
  4. Blood: haematocrit, renal functions, serum electrolytes[citation needed]

Treatment

References

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