volvulus by alam zeb amir
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Volvulus refers to the abnormal twisting of a loop of bowel that occludes both the mesenteric vessels and bowel lumen. It presents with abdominal pain, distension, and lack of flatus or bowel movements. There are several types including midgut, cecal, and sigmoid volvulus. Causes include anatomical variations, muscular dystrophy, intestinal malrotation, abnormal contents, and chronic constipation. Diagnosis involves blood tests, imaging like x-rays, ultrasound, and CT scans. Treatment options are sigmoidoscopic reduction, laparotomy to untwist or resect the bowel, with pre and post-operative care and management of complications.
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Large bowel obstruction is a medical emergency that requires early identification and treatment. It occurs when the flow of intestinal contents is mechanically blocked or the colon dilates abnormally without an anatomical cause. Common causes include cancer, volvulus, diverticulitis, and inflammatory bowel diseases. Symptoms include vomiting, bloating, constipation or lack of gas, and abdominal pain. Diagnosis involves abdominal x-rays, CT scans, barium studies, and blood tests. Initial treatment is insertion of a nasogastric tube. Surgery may be needed to inspect the cause and remove any damaged tissue through laparotomy. Complications can include dehydration, shock, strangulation, gangrene, and perforation if
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Intestinal obstruction is the mechanical impairment which is partial or complete blockage of the bowel that results in the failure of the passage of intestinal content through the intestine.
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- 1. .
- 2. VOLVULUS Alam Zeb Amir Roll no : 09
- 3. VOLVULUS It is the term applied to abnormal twisting of a loop of bowel so that the mesenteric vessel and the lumen of the bowel become occluded.
- 4. Presentation History: Abdominal pain, distension, no flatus or bowel movements Examination: Distension of abdomen, mild tenderness, palpable mass
- 7. CAUSES PREDISPOSING FACTORS One with a normal anatomic variation resulting in extra colonic loops Patients with muscular dystrophy due to the smooth muscle dysfunction Congenital intestinal malrotation Abnormal intestinal contents e.g. meconium ileus or adhesions Chronic constipation
- 8. CLINICAL FEATURES Abdominal distension vomiting Ischemia (Necrosis) Absolute constipation Features of peritonitis Severe pain and progressive injury to the intestinal wall Accumulation of gas and fluid
- 9. DIAGNOSTIC INVESTIGATIONS Laboratory investigations 1. FBC ( WBC) 2. Urea & Electrolytes Plain radiography Contrast studies Other imaging studies 1. Ultrasound 2. CT Scan
- 10. X-RAY
- 11. Barium Enema
- 12. TREATMENT Sigmoidoscopy (sigmoidoscopic reduction) intervention done by untwisting the gut Laparotomy can be done to have a sigmoid resection or untwisting Incision into the abdomen to untwist the knot (volvulus) and possibly resecting any unsalvageable portion
- 13. PRE-OPERATIVE Procedure and relief of psychological stress Low residue diet Antibiotic e.g neomycin, streptomycin, etc Nasogastric or intestinal tube
- 14. POST OPERATIVE Until peristalsis return, anything to be given is introduced parenteral Catheterize Analgesics Manage rectal tube sutured in the anus to facilitate the passage of stool Neostigmine