Sigmoid volvulus HY
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Sigmoid volvulus is a twisting of the sigmoid colon caused by redundancy or dysmotility of the colon, presenting with abdominal distension and discomfort. Diagnosis can be made with imaging showing a dilated, inverted U-shaped loop of colon. Treatment involves endoscopic detorsion with elective surgery or emergency surgery if perforation has occurred to prevent strangulation.
Sigmoid volvulus HY
- 1. Sigmoid volvulus Risk factors • Sigmoid colon redundancy (eg, dilation/elongation from chronic constipation) • Colonic dysmotility (eg, underlying neurologic disorder) Presentation • Slowly progressive abdominal discomfort/distension ± obstructive symptoms (eg, nausea, emesis, obstipation) • Abdomen distended & tympanitic to percussion Imaging • X-ray: dilated, inverted, U-shaped loop of colon (coffee bean sign) • CT scan: dilated sigmoid colon, mesenteric twisting (whirl sign) Management • Endoscopic detorsion (eg, flexible sigmoidoscopy) & elective sigmoid colectomy • Emergency sigmoid colectomy if perforation/peritonitis present