Sigmoid volvulus
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An elderly male presented with acute abdominal distention. Imaging showed dilated small bowel over 2.5-3 cm in diameter and colon over 5 cm in diameter, with the cecum over 8 cm. Small bowel obstruction is most common at 80%, usually from post-surgical adhesions, while large bowel obstruction is 20%, often from colon cancer or diverticulitis. Sigmoid volvulus, more common in elderly and high fiber diets, presents as a twisted sigmoid colon appearing as a large gas-filled structure without haustral markings arising from the pelvis.
Sigmoid volvulus
- 1. Diagnostic Radiology 11/09/2011 Elderly male with acute onset of abdominal distention.
- 8. Dilated Bowel Small bowel - >2.5 to 3 cm in diameter Colon - > 5cm in diameter Cecum - >8cm in diameter
- 9. Statistics Bowel Obstruction Small Bowel Obstruction 80% Large Bowel Obstruction 20% Post-surgical adhesions Colon CA (50-60%) Incarcerated Hernias Diverticulitis Adhesions Volvulus (3-8%) Fecal Impaction Amebiasis Ischemia Adhesions Brant 2006 p 743-745
- 10. Sigmoid Volvulus -most common in the elderly & high residue diet -twists around its mesentery -closed loop obstruction -”Large gas filled without haustral markings arising from the pelvis extending into the abdomen”
- 11. References • Brant , WE and Helms CA. Fundamentals of Diagnostic Radiology. LWW 2006: 743-745. • Sigmoid volvulus in the Middle East. World J Surg. 2008 Mar;32(3):459-64.