33 Sigmoid volvulus Fig. 33.1A This radiograph demonstrates a large gas-filled loop of bowel, arising from the left iliac fossa and pointing to the liver. It has a central sulcus giving it a coffee bean appearance. This is a sigmoid volvulus. The calcified densities in the pelvis are due to fibroids. Background This is a cause of large bowel obstruction, which results from the twisting of a long, redundant loop of sigmoid colon on its mesentery, causing proximal obstruction. It has a quite distinctive appearance on the plain radiograph, which is essential in the diagnostic pathway. Patients with a long redundant sigmoid colon are at risk. These groups include elderly psychiatric patients and patients with chronic constipation who have been on long-term laxatives. It is the commonest type of volvulus. Clinical features These can be rather non-specific but the condition can also present with acute large bowel obstruction – abdominal pain and a tympanic distended abdomen. If not treated, it may lead to perforation and peritonitis. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Large bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Sigmoid volvulus Full access? Get Clinical Tree
33 Sigmoid volvulus Fig. 33.1A This radiograph demonstrates a large gas-filled loop of bowel, arising from the left iliac fossa and pointing to the liver. It has a central sulcus giving it a coffee bean appearance. This is a sigmoid volvulus. The calcified densities in the pelvis are due to fibroids. Background This is a cause of large bowel obstruction, which results from the twisting of a long, redundant loop of sigmoid colon on its mesentery, causing proximal obstruction. It has a quite distinctive appearance on the plain radiograph, which is essential in the diagnostic pathway. Patients with a long redundant sigmoid colon are at risk. These groups include elderly psychiatric patients and patients with chronic constipation who have been on long-term laxatives. It is the commonest type of volvulus. Clinical features These can be rather non-specific but the condition can also present with acute large bowel obstruction – abdominal pain and a tympanic distended abdomen. If not treated, it may lead to perforation and peritonitis. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Large bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join
