Volvulus

Introduction to volvulus Intestinal torsion is a segment of the intestinal tract that rotates along the long axis of the mesentery or twists and twists the two segments of the intestine to cause a closed intestinal obstruction. The former is common. Often because the intestinal fistula and its mesentery are too long, the intestinal lumen is compressed and narrowed after the torsion, causing obstruction, torsion and compression, affecting the blood supply to the intestine. Therefore, the intestinal obstruction caused by intestinal torsion is mostly strangulated. . Intestinal torsion has general intestinal obstruction symptoms, but the onset is rapid, the pain is severe, the patient is restless, shock can occur early, and the intestinal torsion is more common in a clockwise direction. The degree of torsion is less than 360°, and severe cases can reach 2 to 3 Turn, the symptoms are slightly different due to the small intestine or sigmoid torsion. basic knowledge The proportion of illness: 0.0025% Susceptible people: young adults and children are more common. Mode of infection: non-infectious Complications: volvulus syndrome, volvulus, colon torsion, transverse colon torsion, small intestine torsion, cecal torsion, sigmoid torsion

Cause of intestinal torsion

The occurrence of volvulus is seen in a variety of reasons. The anatomical factors are the prerequisites for torsion, and the physiological or pathological factors are the predisposing factors. There are three important factors in the cause of intestinal fistula reversal:

weight:

For example, the weight of the intestinal fistula itself increases, and the relationship between gravity tends to promote the torsion. It is not easy to reset itself after twisting. Therefore, the clinical torsion is common in the full meal, the fiber residue in the food is more, the stool is secreted, and there are mites in the intestinal cavity. There are large tumors on the intestinal wall, congenital megacolon and so on.

External force promotion:

Strong bowel movements and sudden changes in body position, such as the sudden rotation of the body, can also promote the occurrence of intestinal torsion. Therefore, avoid heavy physical labor immediately after a full meal, especially the labor that requires the body to lean forward and rotate. It has a certain significance for preventing intestinal torsion.

length:

The length of the intestinal fistula and its mesentery is relatively longer than the distance between the roots of the two ends of the intestinal fistula, that is, the twist is likely to occur.

Intestinal torsion prevention

Intestinal torsion is a period of intestinal fistula rotating along the long axis of the mesentery or twisting of the two segments of the intestine to cause a closed intestinal obstruction. The former patients have paroxysmal severe cramps in the lower abdomen, abdominal distension, defecation exhaust stops, after the middle It can cause nausea and vomiting, vomit is gastrointestinal contents, pay attention to fasting, gastrointestinal decompression, maintain water and electrolyte balance, anti-infection, and maintain nutrition.

Avoid heavy physical labor immediately after a full meal, especially the labor that requires the body to lean forward and rotate, which has certain significance for preventing intestinal twist.

Intestinal torsion complications Complications TOR twist syndrome volvulus torsion colon torsion transverse colon torsion small intestine torsion cecum torsion sigmoid torsion

The main complications of intestinal obstruction are as follows: 1. Intestinal swelling; 2. Loss of body fluids and electrolytes; 3. Infection and toxemia.

In addition to the above three major pathophysiological changes, such as strangulated intestinal obstruction, often accompanied by oozing in the abdominal wall and intestine of the intestine, the longer the narrowed intestinal fistula, the greater the amount of blood loss is also leading to intestinal obstruction. One of the reasons for the death of the patient.

When the contents of the intestines are blocked, a series of symptoms such as abdominal distension, abdominal pain, nausea and vomiting and defecation disorders may occur, and severe cases may cause blood supply disorders in the intestinal wall, followed by intestinal necrosis, which may lead to death if not actively treated.

Symptoms of bowel torsion Common symptoms Abdominal pain Shock abdominal distension abdominal pain accompanied by nausea, vomiting fecal vomit fecal impaction constipation nausea constipation with severe abdominal pain bowel

Intestinal torsion has general intestinal obstruction symptoms, but the onset is rapid, the pain is severe, the patient is restless, shock can occur early, and the intestinal torsion is more common in a clockwise direction. The degree of torsion is less than 360°, and severe cases can reach 2 to 3 Turn, the symptoms are slightly different due to the small intestine or sigmoid torsion.

Small intestine torsion: acute small intestine torsion is more common in young adults, often with induced factors such as strenuous activity after eating. In children, it is often associated with congenital intestinal malrotation, which is characterized by sudden onset of severe abdominal cramps, mostly around the umbilicus. Often, persistent pain is aggravated; abdominal pain is often involved in the lower back, patients often do not dare to lie on their backs, prefer to take chest or knee or distorted lateral position; frequent vomiting, bloating is not significant or a certain part is particularly obvious, may not Sorghum's bowel sounds, the abdomen can sometimes cramp and tenderness to dilate the intestinal fistula, the course of the disease is later, that is, prone to shock.

Sigmoid colon torsion: more common in older men, often have constipation habits, or have multiple abdominal pain episodes after venting, a history of relief after defecation, clinical manifestations in addition to abdominal cramps, there is significant abdominal distension, and vomiting is generally not obvious.

Intestinal torsion examination

Small bowel torsion: abdominal X-ray examination is consistent with the performance of strangulated intestinal obstruction. In addition, it can also be seen that the jejunum and ileum are transpositiond, or arranged in a variety of forms of small-span tortuous intestinal fistula.

Sigmoid colon torsion: X-ray tincture low-pressure enema is often less than 500ml can not be re-infused, check the torsion site is blocked, the tip of the shadow is "bird's beak" shape.

Diagnosis of gastrointestinal torsion

diagnosis

Can be diagnosed based on clinical performance and laboratory tests. All patients with acute intestinal obstruction should consider the possibility of intrinsic, X-ray examination can confirm the diagnosis.

Differential diagnosis

Need to identify with intussusception, mechanical intestinal obstruction, fecal impaction, tumors, etc. Tumor is a disorder in which the body of a local tissue loses its normal regulation at the genetic level under the action of various carcinogenic factors, resulting in abnormal clonal hyperplasia. Academics generally divide tumors into benign and malignant categories.

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