An abnormal twisting of a portion of the gastrointestinal tract
A colon volvulus is an abnormal twisting of a portion of the gastrointestinal tract which can impair blood flow.
Colon volvulus generally has a sudden onset. The area of intestine above the obstruction caused by the colon volvulus continues to function and fills with food, fluid and gas. This situation can lead to death of the blood-starved tissue and tearing the intestinal wall—life-threatening and a medical emergency.
Symptoms may include:
- Abdominal pain
- Blood in the stool
Sigmoid volvulus, twisting of the sigmoid colon, the S-shaped last part of the large intestine that leads to the rectum, accounts for most cases. Cecal volvulus, twisting of the cecum, the pouch connecting the small and large intestines and ascending colon, occurs less frequently.
Prompt diagnosis and proper treatment generally results in a successful outcome. Diagnostic tests for sigmoid volvulus include X-rays, upper or lower GI series, CT scans and flexible sigmoidoscopy in which the doctor uses a lighted, flexible tube called an endoscope to look inside your rectum and colon. A small camera sends a video image of the intestinal lining to a computer screen, enabling the doctor to see the sigmoid volvulus.
Your doctor may diagnose cecal volvulus using X-rays, upper or lower GI series or CT scans. The imaging will show whether the cecum is out of place and inflated with trapped air.
Volvulus is a surgical emergency that requires immediately freeing the obstruction and ensuring normal blood flow to the bowel. For sigmoid volvulus, the doctor may use the sigmoidoscope to untwist the colon; the volvulus may or may not recur. Otherwise, a surgery called an intestinal resection in which the doctor removes the affected part of the colon and reattaches the healthy ends, will be needed. The resection prevents volvulus from recurring.
For cecal volvulus, a procedure called cecopexy will reposition the cecum and attach it to the abdominal wall. If the cecum is seriously damaged, intestinal resection surgery will be performed.
Both of these procedures have high success rates and generally prevent recurrence.