Volvulus & Intussuseption

8/9/2019 Volvulus & Intussuseption

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Volvulus & Intussusception

Syaiful Mukhtar


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Volvulus

• Volvulus refers to the twisting of aportion of the intestine around itselfor a stalk of mesentery tissue tocause an obstruction. Volvulus occursmost frequently in the colon,although the stomach and small

bowel can also twist


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Volvulus

• he part of the digestive system above thevolvulus continues to function and may swellas it !lls with digested food, "uid, and gas. #

condition called strangulation develops if themesentery of the bowel is twisted so tightlythat blood "ow is cut o$ and the tissue dies.

his condition is called gangrene. Volvulus is a

surgical emergency because gangrene candevelop quickly, cause a hole in the wall ofthe bowel %perforation, and become life'threatenin


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Signs & Symtoms

#bdominal pain) *onstipation) +lood in stool) ausea) Vomiting

+owel obstruction ..


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-astric volvulus


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*aecal volvulus


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Ileal volvulus


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ranversal colon volvulus


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Sigmoid volvulus


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iagnostic

• /hysical e0amination

• 1adiology

•

2ndoscopy


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iagnostic


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reatment

• Surgery

• 1eposition, resection andanastomosis


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Intussusception

• Intussusception is when one segment ofintestine 3telescopes3 inside of anothercausing an intestinal obstruction.

#lthough it can occur anywhere in thegastrointestinal tract, it usually occurs atthe 4unction of the small and largeintestine

• he obstruction can cause swelling &in"ammation that can lead to tearing ofthe intestines


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Intussusception

• Intussusception5s cause is unknown,but is usually preceded by a virusthat produces swelling of the lining of

the intestine, which then prolapsesinto the downstream intestine. Insome children, it is caused by a

congenital anomaly of the intestinesuch as a polyp or diverticulum


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Intussusception


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symptoms ofintussusception

• he characteristic signs and symptoms ofintussusception are episodic, severe, crampyabdominal pain alternating with periods oflethargy. Small children may draw their kneesup to their chest. 6ther possible symptoms ofintussusception include7

• ausea and vomiting

• 1ectal bleeding %red 4elly'like stools sometimesmi0ed with mucus

• hese symptoms begin abruptly, usually oneweek after a non'speci!c viral illness.


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iagnostic

• Intussusception is associated with anabdominal mass, which may be feltupon physical e0amination.

8ltrasonography is able to identifythe mass with 9:: percent accuracyand is now the !rst radiologic test

prescribed for patients withsuspected intussusception. wo otherradiologic tests''barium enema and

air contrast enema''also are used to


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iagnostic


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reatment


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reatment


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reatment

• 6nce intussusception is diagnosed, the ne0t step is toattempt hydrostatic reduction %to push the intestine

back using a barium enema or air contrast enema %sametest used for diagnosis. his is a radiologic procedure not

a surgical procedure and does not require a generalanesthetic.

• hese procedures %barium enema and air contrastenema have a ;: percent to


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hanks u

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Volvulus & Intussuseption