Difference between revisions of "Volvulus"

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#redirect [[Colon#Volvulus]]
'''Volvulus''' is a benign [[colon|colonic]] pathology of the cecum or sigmoid colon.
 
==General==
*Uncommon specimen.
*It is essentially a radiologic [[clinical diagnosis|diagnosis]].
*In the context of [[autopsy]], it is a gross diagnosis.
 
==Gross==
*Intestine folded over itself - typically leads to ischemia.
 
===Radiology===
*In the context sigmoid volvulus - the colon may be described as having a ''coffee bean sign''.<ref name=pmid18559802>{{Cite journal  | last1 = Lee | first1 = YS. | last2 = Lee | first2 = WJ. | title = Coffee-bean sign. | journal = CMAJ | volume = 178 | issue = 13 | pages = 1657 | month = Jun | year = 2008 | doi = 10.1503/cmaj.071760 | PMID = 18559802 }}</ref>
**The "coffee bean" is: large bowel folded over itself and twisted in away that creates two compartments.<ref name=pmid20436903>{{Cite journal  | last1 = Moseley | first1 = BD. | last2 = Bhagra | first2 = A. | title = The coffee bean sign. | journal = Int J Emerg Med | volume = 2 | issue = 4 | pages = 267-8 | month = Nov | year = 2009 | doi = 10.1007/s12245-009-0134-7 | PMID = 20436903 }}</ref>
 
===Images===
<gallery>
File:Volvulus_(Dickdarm).JPG | Volvulus at surgery. (WC)
File:Sigmavolvulus - Coffee-bean-sign - LSL.jpg| X-ray coffee bean sign in volvulus. (WC)
</gallery>
====www====
*[http://library.med.utah.edu/WebPath/GIHTML/GI032.html Cecal volvulus (utah.edu)].
*[http://pathsrvr.rockford.uic.edu/inet/GI/Photo%202%20-%20Volvulus%20of%20small%20intestine_%20gross.gif Volvulus (uic.edu)].<ref>URL: [http://pathsrvr.rockford.uic.edu/inet/GI/GI%20Station%201.htm http://pathsrvr.rockford.uic.edu/inet/GI/GI%20Station%201.htm]. Accessed on: 9 April 2012.</ref>
 
==Microscopic==
Features:
*+/-Ischemic changes and/or [[necrosis]].
 
DDx:
*Essentially anything that causes ischemia:
**Embolus.
**[[Thrombosis]].
**[[Vasculitis]].
**Others.
 
==Sign out==
<pre>
Sigmoid Colon, Excision:
    - Colonic wall with submucosal edema and zonal early degenerative
      change of the mucosa, see comment.
    - Three benign lymph nodes.
    - NEGATIVE for malignancy.
 
Comment:
The clinical and radiologic impression are noted; the changes are compatible with volvulus.
</pre>
 
===Block letters===
<pre>
RECTOSIGMOID, RESECTION:
- MURAL ISCHEMIA WITH PERFORATION, SEROSITIS, MICROABSCESS FORMATION AND POORLY FORMED PSEUDOMEMBRANES.
- SUBMUCOSAL FIBROSIS.
- NEGATIVE FOR MALIGNANCY.
 
COMMENT:
The findings are consistent with volvulus and the submucosal fibrosis suggests this may have been recurrent.
</pre>
 
==See also==
*[[Colon]].
 
==References==
{{Reflist|1}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Colon]]

Latest revision as of 20:37, 12 January 2021

Volvulus is a benign colonic pathology of the cecum or sigmoid colon.

General

  • Uncommon specimen.
  • It is essentially a radiologic diagnosis.
  • In the context of autopsy, it is a gross diagnosis.

Gross

  • Intestine folded over itself - typically leads to ischemia.

Radiology

  • In the context sigmoid volvulus - the colon may be described as having a coffee bean sign.[1]
    • The "coffee bean" is: large bowel folded over itself and twisted in away that creates two compartments.[2]

Images

  • Volvulus at surgery. (WC)

  • X-ray coffee bean sign in volvulus. (WC)

www

Microscopic

Features:

DDx:

Sign out

Sigmoid Colon, Excision:
     - Colonic wall with submucosal edema and zonal early degenerative 
       change of the mucosa, see comment.
     - Three benign lymph nodes.
     - NEGATIVE for malignancy.

Comment:
The clinical and radiologic impression are noted; the changes are compatible with volvulus.

Block letters

RECTOSIGMOID, RESECTION:
- MURAL ISCHEMIA WITH PERFORATION, SEROSITIS, MICROABSCESS FORMATION AND POORLY FORMED PSEUDOMEMBRANES.
- SUBMUCOSAL FIBROSIS.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
The findings are consistent with volvulus and the submucosal fibrosis suggests this may have been recurrent.

See also

References

  1. ↑ Lee, YS.; Lee, WJ. (Jun 2008). "Coffee-bean sign.". CMAJ 178 (13): 1657. doi:10.1503/cmaj.071760. PMID 18559802.
  2. ↑ Moseley, BD.; Bhagra, A. (Nov 2009). "The coffee bean sign.". Int J Emerg Med 2 (4): 267-8. doi:10.1007/s12245-009-0134-7. PMID 20436903.
  3. ↑ URL: http://pathsrvr.rockford.uic.edu/inet/GI/GI%20Station%201.htm. Accessed on: 9 April 2012.
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