Description

Sigmoid volvulus is a medical condition characterized by the twisting or rotation of the sigmoid colon, which is the S-shaped portion of the large intestine located just before the rectum. This rotation causes a blockage in the bowel and can lead to a range of symptoms and complications. Causes of sigmoid volvulus The exact cause of sigmoid volvulus is not always clear, but certain factors can contribute to its development. These include: 1. Abnormal Anatomy: Some individuals may have a longer or more mobile sigmoid colon, making it more susceptible to twisting. 2. Chronic Constipation: Chronic constipation and the resulting buildup of stool can increase the risk of sigmoid volvulus. 3. Aging: Sigmoid volvulus is more commonly observed in older adults, as the colon may become more lax and prone to twisting. Symptoms of sigmoid volvulus The symptoms of sigmoid volvulus can vary depending on the severity of the condition. Here are the common symptoms associated with sigmoid volvulus: 1. Abdominal Pain: Sigmoid volvulus typically presents with sudden, severe, and crampy abdominal pain. The pain is usually located in the lower left side of the abdomen but can sometimes be generalized. 2. Abdominal Distension: The twisting of the sigmoid colon causes a blockage, leading to the accumulation of gas and stool. This results in abdominal distension, making the abdomen appear swollen and tense. 3. Constipation: The blockage in the sigmoid colon can cause a significant reduction or cessation of bowel movements, leading to constipation. In some cases, there may be a history of chronic constipation before the volvulus occurs. 4. Nausea and Vomiting: Sigmoid volvulus can cause nausea and vomiting, which may be associated with the abdominal pain and obstruction. 5. Absence of Bowel Sounds: Due to the obstruction, there may be a lack of normal bowel sounds upon auscultation of the abdomen. 6. Rectal Bleeding: In some cases, sigmoid volvulus can lead to rectal bleeding. This occurs when the twisted segment of the sigmoid colon becomes ischemic or necrotic, resulting in the release of blood into the stool. 7. Symptoms of Intestinal Obstruction: As the volvulus progresses, it can lead to symptoms of intestinal obstruction, such as bloating, inability to pass gas or stools, and further worsening of abdominal pain. It's important to note that sigmoid volvulus is a medical emergency and requires immediate medical attention. If you suspect sigmoid volvulus or experience severe abdominal pain with abdominal distension, it is essential to seek prompt medical care. Diagnosis of sigmoid volvulus When sigmoid volvulus is suspected, several investigations are typically performed to confirm the diagnosis and assess the severity of the condition. These investigations may include: 1. Physical Examination: A thorough physical examination is conducted, including assessing the abdomen for distension, tenderness, and signs of peritonitis (inflammation of the abdominal lining). 2. Imaging Studies: • Abdominal X-ray: An X-ray of the abdomen can often provide initial evidence of sigmoid volvulus. It may show a characteristic "coffee bean" or "omega" sign, which represents the twisted sigmoid colon. • Computed Tomography (CT) Scan: CT scan is a more detailed imaging technique that can provide a clearer visualization of the twisted sigmoid colon, assess the degree of bowel obstruction, and identify any complications such as bowel ischemia or perforation. 3. Blood Tests: Blood tests may be done to evaluate the overall health status, check for signs of infection or inflammation (elevated white blood cell count), and assess electrolyte levels. 4. Flexible Sigmoidoscopy or Colonoscopy: These endoscopic procedures involve the insertion of a flexible tube with a camera into the rectum and sigmoid colon. They can help visualize the volvulus, assess the extent of the twist, and evaluate the condition of the bowel lining. It's important to note that the investigations performed may vary depending on the specific situation and the clinical judgment of the healthcare provider. The aim of these investigations is to confirm the diagnosis, assess the severity of the volvulus, and determine the appropriate management approach, which may involve non-surgical or surgical intervention.