🥚 Gastrointestinal🟢 BasicLarge Intestine

Sigmoid Volvulus

A twisting of the loose sigmoid colon on its stalk, which blocks the bowel and can cut off its blood supply.

Key points

A volvulus is a twist of a loop of bowel around its mesentery, and the sigmoid colon is the commonest site because it is long and mobile.
The twist blocks the passage of bowel contents, causing a large-bowel obstruction with marked swelling of the abdomen.
It causes colicky pain, gross distension, absolute constipation, and vomiting that comes later than in a small-bowel obstruction.
An abdominal X-ray shows a hugely dilated loop rising from the pelvis, likened to a coffee bean or an inverted U.
If the twist is tight enough to cut off the blood supply, the bowel can die (gangrene), which is life-threatening.

Memory trick

Sigmoid volvulus is a twist of the long, mobile sigmoid, giving a large-bowel obstruction: colicky pain, gross distension, constipation and late vomiting; the X-ray shows a coffee-bean loop; a tight twist causes gangrene.

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🥚 Gastrointestinal🟢 BasicLarge Intestine

Sigmoid Volvulus

A twisting of the loose sigmoid colon on its stalk, which blocks the bowel and can cut off its blood supply.

Key points

A volvulus is a twist of a loop of bowel around its mesentery, and the sigmoid colon is the commonest site because it is long and mobile.
The twist blocks the passage of bowel contents, causing a large-bowel obstruction with marked swelling of the abdomen.
It causes colicky pain, gross distension, absolute constipation, and vomiting that comes later than in a small-bowel obstruction.
An abdominal X-ray shows a hugely dilated loop rising from the pelvis, likened to a coffee bean or an inverted U.
If the twist is tight enough to cut off the blood supply, the bowel can die (gangrene), which is life-threatening.

Memory trick

All of General Surgery More Gastrointestinal