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Colonic Volvulus

  • Jan Rakinic
Chapter

Abstract

Volvulus, from the Latin volvere, means “to twist.” Volvulus may occur in any part of the gastrointestinal tract where there is sufficient length of gut to twist about a fixed point. Colonic volvulus is the cause of 10–15% of colon obstruction in USA.1,2 Colonic volvulus occurs when a mobile portion of the colon has a mesentery with a narrow, fixed base. The colonic segment twists around this fixed point, producing a closed loop obstruction. The mesenteric narrowing may be congenital or acquired, often by surgical scarring near the mesenteric root. As may be anticipated, the most common sites of colonic volvulus are the sigmoid colon and cecum, which are the most mobile parts of the colon. In a series of 546 cases of colonic volvulus in USA, the site-specific incidence was found to be cecum, 34.5%; transverse colon, 3.6%; splenic flexure, 1%; and sigmoid colon, 60.9%.3 A more recent Australian study had incidence as follows: cecum, 39%; transverse colon, 2%; and sigmoid colon, 59%.4 Factors that place patients at elevated risk for colonic volvulus include chronic constipation, previous abdominal surgery, and megacolon.

Notes

Acknowledgments.

This chapter was written by Michael D. Hellinger and Randolph M. Steinhagen in the first edition of this textbook.

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Copyright information

© ASCRS (American Society of Colon and Rectal Surgeons) 2011

Authors and Affiliations

  • Jan Rakinic
    • 1
  1. 1.Section of Colorectal Surgery, Department of SurgerySouthern Illinois University School of MedicineSpringfieldUSA

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