Volvulus causes
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Overview
Midgut volvulus occurs in patients (usually in infants) that are predisposed because of congenital intestinal malrotation. Segmental volvulus occurs in patients of any age, usually with a predisposition because of abnormal intestinal contents (e.g. meconium ileus) or adhesions. Volvulus of the cecum, transverse colon, or sigmoid colon occurs, usually in adults, with only minor predisposing factors such as redundant (excess, inadequately supported) intestinal tissue and constipation.
Causes
Causes of volvulus can either be congenital or acquired:
- Acquired causes of volvulus include:[1][2][3]
- Adhesions
- Iatrogenic e.g. lower GI endoscopy
- Bowel atony
- Hirschsprung's disease
- Pregnancy
- Chrohn's disease
- Chaga's disease
- Congenital causes of volvulus include:[4]
- Narrow mesenteric base
- The midgut becomes suspended by a narrow pedicle.
- Non-rotation
- In non-rotation, the primary loop undergoes no further rotation during its return to the abdominal cavity.
- The small bowel becomes located on the right whilst the colon is on the left of the abdomen.
- Non-rotation is less dangerous than malrotation because in non-rotation, the mesentery is wider and the risk of volvulus is lower.
- Malrotation
- In malrotation, the proximal (duodenojejunal) limb remains in a position of non-rotation, and the distal (cecocolic) limb partially rotates (usually only 90 degrees instead of 180 degrees).
- Narrow mesenteric base
References
- ↑ John H, Gyr T, Giudici G, Martinoli S, Marx A (1996). "Cecal volvulus in pregnancy. Case report and review of literature". Arch. Gynecol. Obstet. 258 (3): 161–4. PMID 8781706.
- ↑ Radin DR, Halls JM (1986). "Cecal volvulus: a complication of colonoscopy". Gastrointest Radiol. 11 (1): 110–1. doi:10.1007/BF02035046. PMID 3943670.
- ↑ Sarioğlu A, Tanyel FC, Büyükpamukçu N, Hiçsönmez A (1997). "Colonic volvulus: a rare presentation of Hirschsprung's disease". J. Pediatr. Surg. 32 (1): 117–8. PMID 9021588.
- ↑ Burns, Cartland (2006). "Principles and Practices of Pediatric Surgery". Annals of Surgery. 243 (4): 567. doi:10.1097/01.sla.0000208423.52007.38. ISSN 0003-4932.