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Sigmoid volvulus in the young. A case following cesarean section
Archives of Surgery (Chicago, Ill. : 1960)
|March 1, 1978
Summary
Sigmoid volvulus is more common in younger patients and females than previously believed. Diagnosis involves abdominal pain, constipation, distention, and specific X-ray findings, with surgery as the primary treatment.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Sigmoid volvulus is a condition where the sigmoid colon twists on its mesentery.
- It is often associated with chronic constipation and abdominal distention.
Observation:
- This condition occurs more frequently in younger individuals and females than commonly recognized.
- Typical symptoms include colicky abdominal pain, prolonged constipation or obstipation, and progressive abdominal distention over several days.
- A history of similar episodes increases diagnostic suspicion.
Findings:
- Abdominal X-rays commonly show significant colonic dilation extending to a point in the sigmoid, with rectal gas absent.
- While the classic "horseshoe" sign is rarely observed, its presence strongly supports the diagnosis.
- Factors such as surgical manipulation and pregnancy can contribute to sigmoid volvulus.
Implications:
- Early recognition of sigmoid volvulus in younger and female populations is crucial.
- Diagnostic imaging plays a key role, though classic signs are infrequent.
- Surgical intervention is the standard treatment unless specific contraindications exist.