Volvulus

Article summary

A volvulus is a bowel obstruction resulting from a loop of intestine twisting around itself and its supporting mesentery. Symptoms include abdominal pain, abdominal bloating, vomiting, constipation, and bloody stool. Onset of symptoms may be rapid or more gradual. The mesentery may become so tightly twisted that blood flow to part of the intestine is cut off, resulting in ischemic bowel. In this situation there may be fever or significant pain when the abdomen is touched. Risk factors include a birth defect known as intestinal malrotation, an enlarged colon, Hirschsprung disease, pregnancy, and abdominal adhesions. Long term constipation and a high fiber diet may also increase the risk. The most commonly affected part of the intestines in adults is the sigmoid colon, with the cecum being the second most affected. In children the small intestine is more often involved. The stomach can also be affected. Diagnosis is typically with medical imaging such as plain X-rays, a GI series, or CT scan. Initial treatment for sigmoid volvulus may occasionally occur via sigmoidoscopy or with a barium enema. Due to the high risk of recurrence, a bowel resection within the next two days is generally recommended. If the bowel is severely twisted or the blood supply is cut off, immediate surgery is required. In a cecal volvulus, often part of the bowel needs to be surgically removed.…

Key claims

No claims recorded.

Discussion questions

1. Summarise the article in your own words. Which single claim would you verify first, and why?
2. Which claim in this article is most likely to be revised as the sources update? How would you check its current status?
3. If two sources disagreed about one of these facts, what would you need in order to trust one over the other?

Bibliography

No sources recorded.