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Difference between revisions of "Volvulus"
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'''Volvulus''' is a benign [[colon|colonic]] pathology. | '''Volvulus''' is a benign [[colon|colonic]] pathology of the cecum or sigmoid colon. | ||
==General== | ==General== | ||
* | *Uncommon specimen. | ||
*It is essentially a radiologic diagnosis. | *It is essentially a radiologic [[clinical diagnosis|diagnosis]]. | ||
*In the context of [[autopsy]], it is a gross diagnosis. | *In the context of [[autopsy]], it is a gross diagnosis. | ||
==Gross== | ==Gross== | ||
*Intestine folded over itself - typically leads to ischemia. | *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=== | ===Images=== | ||
<gallery> | <gallery> | ||
File:Volvulus_(Dickdarm).JPG | Volvulus at | File:Volvulus_(Dickdarm).JPG | Volvulus at surgery. (WC) | ||
File:Sigmavolvulus - Coffee-bean-sign - LSL.jpg| X-ray coffee bean sign in volvulus. (WC) | |||
</gallery> | </gallery> | ||
====www==== | ====www==== | ||
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*+/-Ischemic changes and/or [[necrosis]]. | *+/-Ischemic changes and/or [[necrosis]]. | ||
DDx | DDx: | ||
*Embolus. | *Essentially anything that causes ischemia: | ||
*[[Thrombosis]]. | **Embolus. | ||
*[[Vasculitis]]. | **[[Thrombosis]]. | ||
**[[Vasculitis]]. | |||
**Others. | |||
==Sign out== | ==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> | <pre> | ||
RECTOSIGMOID, RESECTION: | RECTOSIGMOID, RESECTION: | ||