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Colonic Volvulus

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The ASCRS Textbook of Colon and Rectal Surgery

Abstract

Volvulus, from the Latin volvere, means “to twist.” Volvulus may occur in any part of the gastrointestinal tract where there is sufficient length of gut to twist about a fixed point. Colonic volvulus is the cause of 10–15% of colon obstruction in USA.1,2 Colonic volvulus occurs when a mobile portion of the colon has a mesentery with a narrow, fixed base. The colonic segment twists around this fixed point, producing a closed loop obstruction. The mesenteric narrowing may be congenital or acquired, often by surgical scarring near the mesenteric root. As may be anticipated, the most common sites of colonic volvulus are the sigmoid colon and cecum, which are the most mobile parts of the colon. In a series of 546 cases of colonic volvulus in USA, the site-specific incidence was found to be cecum, 34.5%; transverse colon, 3.6%; splenic flexure, 1%; and sigmoid colon, 60.9%.3 A more recent Australian study had incidence as follows: cecum, 39%; transverse colon, 2%; and sigmoid colon, 59%.4 Factors that place patients at elevated risk for colonic volvulus include chronic constipation, previous abdominal surgery, and megacolon.

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Acknowledgments.

This chapter was written by Michael D. Hellinger and Randolph M. Steinhagen in the first edition of this textbook.

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Authors and Affiliations

  1. Section of Colorectal Surgery, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA

    Jan Rakinic MD

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  1. Jan Rakinic MD
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Editors and Affiliations

  1. Department of Colon and Rectal Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA

    David E. Beck MD, FACS, FASCRS

  2. Department of Colorectal Surgery, Lahey Clinic, Tufts University School of Medicine, Burlington, Massachusetts, USA

    Patricia L. Roberts MD, FACS, FASCRS

  3. Section of Colon and Rectal Surgery, Rush Medical Center, Chicago, Illinois, USA

    Theodore J. Saclarides MD, FACS, FASCRS

  4. Department of Surgery, Spectrum Health, Grand Rapids, Michigan, USA

    Anthony J. Senagore MD, FACS, FASCRS

  5. Department of Surgery, UCI Medical Center, Orange, California, USA

    Michael J. Stamos MD, FACS, FASCRS

  6. Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA

    Steven D. Wexner MD, FACS, FASCRS, FRCS, FRCS(Ed)

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© 2011 ASCRS (American Society of Colon and Rectal Surgeons)

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Rakinic, J. (2011). Colonic Volvulus. In: Beck, D.E., Roberts, P.L., Saclarides, T.J., Senagore, A.J., Stamos, M.J., Wexner, S.D. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1584-9_23

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