SIGN AND SYMPTOM1.May present as abdominal emergency-Acute distension-Colicky pain (spasm)-Failure to pass flatus or stool (constipation is prevailing feature)-Vomiting is late sign2.Rapid heart rate.3.Rapid breathing.
PATHOPHYSIOLOGY• Redundant sigmoid colon that has a narrow mesenteric attachment to posterior abdominal wall allows close approximation of 2 limbs of sigmoid colon à
DIAGNOSTIC TEST1. X-r ays — A bdom nal X-r ays m show i ayobst r uct i on and abnor m ai r -f l ui d l evel s al oi ,i i n t he si gm d and cecum n m dgut i vol vul us, abdom nal X-r ays m be i aynor m . al2. W t e bl ood cel l count — In strangulation, the hi count is greater than 15,000/µl, in bowel infarction, greater than 20,000/µl.
CON’T…3.B i umenem — I n cecal vol vul us, ar a bar i umf i l l s t he col on di st al t o t he sect i on of cecum .4.C put ed t om aphy scan — m show om ogr ay evi dence of i nt est i nal obst r uct i on.
TREATMENT1.For children with midgut volvulus, surgery is required.2. For adults with sigmoid volvulus, nonsurgical treatment includes proctoscopy to check for infarction and reduction by careful insertion of a flexible sigmoidoscope to deflate the
TREATMENT3.Untwisting by performing sigmoidoscopy and placing rectal tube, monitor for signs of bowel ischemia for 2-3 days, if no improvement, consult surgery for laparotomy (sigmoid resection and primary anastamosis)