Therapeutic care of volvulus of sigmoid colon in emergency is controversial. The area of intestine above the obstruction caused by the colon volvulus continues to function and fills with food, fluid and gas. The mesentery of the right colon creates a pouch, the small bowel then herniates into it. Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Colon volvulus digestive diseases i ohio state medical. Torsion results in narrowing of the lumen at the point of rotation and compromise of the vessels that supply the torted gut. Abdominal xray abnormal bowel gas pattern volvulus. The two commonest types of bowel twisting are sigmoid volvulus and caecal volvulus.
Il sagit dune etude retrospective qui a porte sur 10 ans janvier 2000 decembre 2009. Volvulus of other portions of the alimentary tract, such as the stomach, gallbladder, small bowel, splenic flexure, and. Les volvulus du colon sont une cause rare mais grave docclusion colique organique 1% occlusions intestinales. Volvulus colon sigmoidetraitement chirurgical colectomie ideale colostomie tchad introduction le volvulus du colon pelvien ou sigmoide est une occlusion par strangulation provoquee par une torsion du sigmoide sur son propre meso. In order for a vessel to be compressed and obstructed, the force that the torsion imparts on the vessel needs to be greater. A transverse colon volvulus was found, and an extended right. Ils constituent une urgence diagnostique et therapeutique. The mesentery anchors the ileum and sigmoid colon to the posterior abdominal wall. Xtolvulus of the colon is an uncommon but lethal cause of large bowel obstruction. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Determine the frequency of sigmoid colon volvulus, describe clinical and paraclinical signs. Intestinal malrotation and volvulus intestinal malrotation is a defect that occurs at the 10th week of gestation. Volvulus is defined as a torsion of a portion of the gastrointestinal tract. Cours gratuits gastrologie le volvulus du colon pelvien.
In volvulus, a loop of intestines is twisted at a point along the mesentery that is attached. The area of intestine above the obstruction continues to function and fills with food, fluid, and gas. Intestinal volvulus is defined as a complete twisting of a loop of intestine around its mesenteric attachment site. Its the most common form of volvulus of the gastrointestinal tract and is a. Intestinal volvulus is a broad term that describes the torsion of bowel around its mesentery. The mesentery may become so tightly twisted that blood flow to the affected part of the. The most common sites of volvulus are the sigmoid colon and cecum. Listing a study does not mean it has been evaluated by the u. Sigmoid volvulus is the mostcommon form of volvulus of the gastrointestinal tract. The medical literature is studded with cases of volvulus of the colon.
Plain radiographs were suggestive of a large bowel obstruction due to volvulus. Small bowel volvulus is an uncommon but important cause of small intestinal obstruction. A 75year old male presented to the emergency room with worsening abdominal pain and distension. Volvulus of the cecum as a postoperative complication. Colonic volvulus affects between three and seven million people per year worldwide. For examples, perlman 1 reported 111 cases from a russian clinic, griffin, bartron and meyer 2 discussed 37 cases in patients admitted to cook county hospital between 1937 and 1945, and braun and wortman 3 listed 31 cases seen at friedrichshain hospital in berlin when the incidence of volvulus is applied to the. In the context sigmoid volvulus the colon may be described as having a coffee bean sign. Cette pathologie touche tous les segments mobiles du colon. The sigmoid colon volvulus is a common cause of intestinal obstruction in africa.
It is a common cause of bowel obstruction and constipation. Volvulus twist of the bowel around its own mesentery. The sigmoid colon is more prone to twisting than other segments of the large bowel because it is mobile on its own mesentery, which arises from a fixed point in the left iliac fossa lif. Identifying the different kinds of anatomical sigmoid colon in our environment and determine what exposes the most to the occurrence of pelvic colon volvulus. The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop around its mesenteric axis resulting in partial or complete obstruction of the colonic lumen. Volvulus twisting of the colon volvulus occurs when the intestine twists around itself and the mesentery that supports it, creating an obstruction. Delay in diagnosis and surgical intervention increases morbidity and mortality rates. Volvulus occurs most frequently in middleaged and elderly men. A volvulus is surgical condition that results in a loop of the bowel twisting on itself. The age distribution and underlying causes for each part of the intestine is quite different and can present the surgeon with a diagnostic dilemma leading to an abdominal catastrophe if the volvulus is not diagnosed and treated promptly. This work aimed to describe the treatment of sigmoid volvulus in ndjamena, chad. Volvulus of the small bowel and colon remains a significant cause for surgical emergencies in both children and adults.
If the diagnosis of volvulus is set on time patients need not be operated and the normal passage of the stool can be perfectly achieved by minor medical procedures such as colonoscopy or sigmoidoscopy. An attempt to detorse the volvulus and decompress the colon endoscopically failed, after which the patient was taken for an exploratory laparotomy. This can be a life threatening condition due to the loss of blood supply and accumulation of toxic gases. Le volvulus du sigmoide est une urgence medicochirurgicale frequente. Colonic volvulus may involve the cecum and terminal ileum, the transverse colon, the splenic flexure or the sigmoid colon. Le volvulus du colon pelvien ou sigmoide est une occlusion par strangulation. A colon volvulus is an abnormal twisting of a portion of the gastrointestinal tract which can impair blood flow. An air filled loop of the sigmoid colon or the terminal ileum, sometimes, twists. Based on cause, small bowel volvulus can be divided into primary and secondary type. Volvulus twist of the bowel around its own mesentery closed loop obstruction obstruction of the bowel at 2 points in 1 location strangulation obstruction of the bowel with interruption of its blood supply.
Another issue is the higher prevalence of sigmoid volvulus in men than women. Volvulus, derived from the latin term volvere, is a subtype of abnormal gastrointestinal gi rotation. This was a retrospective descriptive study realized in the. There are no predictors for developing volvulus with ischemia and surgery remains to be the. Il survient le plus frequemment chez le sujet age mais il peut apparaitre a tout age. It is related to but not precisely synonymous with malrotation, a more general term used when the normal process of rotation and fixation of the midgut goes awry. Still this condition is most commonly followed by certain complications. A prospective randomized trial the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
It is the most common intestinal volvulus and is an absolute medical and surgical emergency. It is a very common cause of large bowel obstruction in peru and bolivia due to high altitude. Volvulus can also arise as a rare complication in persons with redundant colon, a normal anatomic variation resulting in extra colonic loops. Volvulus refers to torsion of a segment of the alimentary tract, which often leads to bowel obstruction. The cecum is the second location of the colon volvulus after sigmoid. Volvulus du sigmoide, devolvulation endoscopique, resection. It represents 1 % of acute intestinal mechanical obstruction and 20 to 40% of colon volvulus 2, 3. We need to determine whether the patient with suspected volvulus has a viable colon and is a candidate \. Malrotation and volvulus in adults boyoung song, md suny downstate.
Le volvulus du colon pelvien blog du chalet espace des. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. Such a type of condition can gradually lead to tissue death. Pdf volvulus of sigmoid colon at sikasso hospital researchgate. The disorder is characterized by twisting of intestine that obstructs the blood supply. It is common in asia, india 7% of intestinal obstruction and especially south india because of the high fibre diet.
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