Article Sections

Introduction

Volvulus refers to the twisting of a segment of bowel around its mesenteric attachment, leading to obstruction and potential compromise of blood flow.  The sigmoid colon and cecum are the most commonly affected sites in adults.  Presenting symptoms include the progressive onset of colicky abdominal pain and distension, and the diagnosis is confirmed with imaging.  Volvulus is a surgical emergency due to the risk of developing ischemia and subsequent necrosis of the affected bowel segment.

Pathogenesis

Volvulus occurs when a loop of bowel twists around its mesenteric axis.  This can lead to mechanical obstruction and impaired perfusion.  The degree of obstruction and ischemia varies depending on the extent and duration of twisting, which is typically between 180° and 360°.

The pathophysiology primarily involves:

  • Bowel obstruction:

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