transverse colon volvulus
Introduction
Introduction to transverse colon torsion Transverse colon torsion refers to the clinical reversal of transverse colon fistula. Often combined with other congenital malformations. It is associated with excessive activity of the spleen of the transverse mesenteric colon, and congenital or abdominal surgery adhesions, chronic constipation, distal obstructive lesions, and pregnancy may also be contributing factors, which can be formed when twisted to 270°. Closed strangulated intestinal obstruction. basic knowledge Proportion of the disease: the incidence rate in the middle-aged and elderly population is about 0.002%, related to constipation Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis
Cause
Transverse colon torsion
Primary factor (65%):
Transverse colon torsion and its mesangial is too long, the activity of the spleen is too large, congenital or abdominal surgery adhesions.
Other disease factors (35%):
Chronic constipation, distal obstructive lesions, and pregnancy may also be contributing factors, and when twisted to 270°, a closed strangulated intestinal obstruction can be formed.
Prevention
Transverse colonic torsion prevention
prevention:
Colon torsion is easy to be complicated by intestinal necrosis, and patients are often old, so the mortality rate and recurrence rate are high. Therefore, timely diagnosis and treatment of this disease is the main key to reduce the recurrence rate and mortality.
Complication
Transverse colon torsion complications Complications peritonitis
In severe cases, the abdomen with asymmetrical bulge and irregular flatulence can be seen. If it cannot be reset in time, the flatulence and intestinal fistula may cause intestinal wall necrosis, perforation, peritonitis and even death due to intestinal narrowing.
Symptom
Transverse colon torsion symptoms Common symptoms Abdominal pain with nausea, vomiting, bloating, colonic vascular dysplasia, nausea, constipation, fecal vomit, transverse colon, sag, fecal impact, intestinal stimuli
The transverse colon torsion has a rapid onset, which is characterized by acute mechanical intestinal obstruction. In addition to paroxysmal cramps in the upper abdomen, there is obvious abdominal distension, vomiting is relatively light, occurs late, and can be excreted without defecation.
Signs: Abdominal examination, showing abdominal distension asymmetry, the upper abdomen can touch the intestinal fistula of dilatation and tenderness, the percussion is drum sound, the early bowel sounds are hyperthyroidism, the sound of gas can be heard, and some cases are slow and can be recurrent. The symptoms are not obvious.
Examine
Transverse colonic torsion
Abdominal fluoroscopy or plain film shows a large amount of gas in the colon, a large gas-liquid plane in the upper abdomen, obstruction of the transverse colon in the barium enema, and a bird's-eye shadow.
Diagnosis
Transverse colon torsion diagnosis
The patient had sudden upper abdominal cramps, abdominal distension, nausea, vomiting, episodes of upper abdominal cramps, and the anus stopped defecation. X-ray examination revealed a markedly dilated colonic fistula and a proximal right colonic dilatation. The barium enema shows that the transverse colon has a beak-like shadow to confirm the diagnosis.
Due to changes in the position of the transverse colon can be misdiagnosed as the sigmoid colon, should be identified.
