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'''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]] |
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