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What Is a Colonic Volvulus (Twisted Colon)?

Colonic volvulus is a condition whereby the twisting of a movable segment of the bowel around its mesenteric axis results in a partial or complete colonic obstruction, possible injury to the bowel, and potential tissue death due to a lack of oxygen-rich blood from the compromised state of the blood supply.

The mesenteric axis is comprised of a double layer of membrane that lines the abdominal cavity, covering most of the abdominal organs. This membrane attaches to the back wall of the abdominal cavity and supports the small intestines.

Colonic volvulus is also known as twisted colon, bowel torsion, torsion of the ascending colon, closed-loop obstruction of the ascending colon and cecum, axial torsion, cecal bascule, cecal volvulus, sigmoid volvulus, or transverse volvulus.

There are generally three types of colonic volvulus, or twisted colon. Their names correspond to the affected section of the colon: volvulus cecal/caecum, volvulus sigmoid colon (midgut), and volvulus transverse.

          

Volvulus most frequently afflicts middle-aged and elderly men. Approximately ninety-five percent of colonic volvulus cases are cecal volvulus and sigmoid volvulus.¹ Sigmoid volvulus is especially common in elderly and constipated persons.

Symptoms of Colonic Volvulus (Twisted Colon)

• Severe abdominal distention
• Nausea
• Severe constipation
• Frequent pain, though severity is variable

Diagnosis and Treatment of Colonic Volvulus (Twisted Colon)

Diagnosis is normally confirmed using an abdominal radiography X-ray.

Colonic volvulus is a closed loop obstruction requiring immediate intervention as it affects the blood flow in the bowel, and results in an accumulation of fluid and gas in the affected portion of the obstructed bowel. Impaired blood flow can cause tissue death and, therefore, requires immediate surgical intervention in order to minimize damage from loss of blood to the bowel, and to resolve the obstruction.

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Notes:
1. Michael Santoro, MD, MedicineNet.com, "Colon Polyps," MedicineNet.com http://www.medicinenet.com/colon_cancer/article.htm (accessed December 10, 2007).
2. National Digestive Diseases Information Clearinghouse (NDDIC), "What I need to know about Colon Polyps," http://digestive.niddk.nih.gov/ddiseases/pubs/colonpolyps_ez/ (accessed December 10, 2007).