What is a volvulus sigmoid colon?
Pathophysiology — Sigmoid volvulus occurs when an air-filled loop of the sigmoid colon twists about its mesentery. Obstruction of the intestinal lumen and impairment of vascular perfusion occur when the degree of torsion exceeds 180 and 360 degrees, respectively [24].
What is acute cecal volvulus?
A cecal volvulus is the rotation or torsion of a mobile cecum and ascending colon, which causes approximately 1 to 3 percent of all large bowel obstructions [1-3]. If untreated, cecal volvulus can progress to bowel ischemia, necrosis, or perforation [4-8].
Which mechanical intestinal obstruction commonly involves the sigmoid due to twisting of mesentery?
A volvulus is a twisting or folding of the colon on its mesentery. Volvulus of the colon can induce an acute intestinal obstruction. The most frequent volvulus is a sigmoid volvulus, followed by cecal volvulus.
What is a reduction of an intestinal volvulus?
The process of untwisting the intestines is called “reducing” the volvulus. In order to accomplish this, a flexible sigmoidoscopy is performed first. A sigmoidoscopy can reduce the sigmoid volvulus when it is advanced through the twisted segment of the colon.
Is a sigmoid volvulus life-threatening?
In addition, the blood supply may be reduced, leading to injury or death of the tissues of that part of the colon. If not treated quickly, this can result in a perforation, a hole in the bowel through which stool and gas can spill into the abdomen. Perforations can be fatal without urgent intervention.
Why is cecal volvulus an emergency?
The management of cecal volvulus requires prompt (emergency) diagnosis and prompt surgical intervention. Any delay in diagnosis may lead to intestinal necrosis or perforation and worsening the prognosis in patients who are generally elderly.
What causes cecal volvulus?
Cecal volvulus is caused by axial twisting of the cecum along with the terminal ileum and ascending colon [2]. It is responsible for approximately 1–1.5% of all intestinal obstructions, while 11% of all volvulus-related intestinal obstructions, and its incidence is 2.8–7.1 cases per million annually [1].
What happens if volvulus is left untreated?
If left untreated, volvulus can result in serious health complications, including recurrent volvulus, gangrene, faecal peritonitis, perforation of the bowel, and gangrene.
What is a Hartmann pouch?
This blind limb is called a Hartmann pouch Sometimes the choice to make a Hartmann pouch is up to the surgeon, but sometimes not enough sigmoid colon is left after surgery to allow externalisation, in which case a Hartmann pouch has to be formed (as part of a Hartmann procedure). Complications A Hartmann pouch may be complicated by 3:
What happened to the Forgotten pouch after Hartmann’s surgery?
The fate of the forgotten rectal pouch after Hartmann’s procedure without reconstruction The rectal pouches of 45 patients who underwent Hartmann’s procedure and were not scheduled to have a colostomy closure were examined with an endoscope at least 1 year after operation.
What causes Hartmann’s pouch on the gallbladder?
Macroscopically, in all the gallbladders with Hartmann’s pouch, the pouch was observed to result from adhesions between the cystic duct and the neck of the gallbladder. After cleavage of these adhesions, the phenomenon of Hartmann’s pouch was abolished in all cases.
What is Hartmann’s procedure?
Hartmann’s procedure is a kind of colectomy that removes part of the colon and sometimes rectum (proctosigmoidectomy). The remaining rectum is sealed, creating what is known as Hartmann’s pouch. The remaining colon is redirected to a colostomy.