Volvulus

Twisting of an intestinal loop around its own axis, possible because practically all the small intestine and a small section of the large intestine (sigmoid colon) are attached to the abdominal wall only by a single membrane containing the intestinal blood vessels. Volvulus is a very rare condition, usually congenital in children; volvulus of the sigmoid usually occurs in older patients as a result of constipation. It is common among some tropical peoples. The clinical picture is the same as that of acute intestinal obstruction (ileus), and the blood vessels are strangulated, causing eventual death of the affected section. On examination, it is not essential to distinguish between this and other causes of obstruction: possible obstruction is grounds enough to institute surgery, because of the risk of intestinal perforation and shock. If the affected

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