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Volvulus
- Twisting of intestinal loop around attachment to mesentery
- Can occur at Stomach (Gastric Volvulus), Small Intestine, cecum, transverse colon or sigmoid colon
- Typically occurs in elderly
- Sigmoid Volvulus
- Abdominal Pain
- Abdominal Distention
- Obstipation (unable to pass stool or Flatus)
- Vomiting is a late and ominous sign
- Abdominal exam may be benign
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Heme positive stool
- Late sign suggesting infarcted bowel
- See Abdominal Pain Causes
- Intestinal infarction (high mortality)
- Emergent surgical management
- Mesenteric Infarction and necrosis starts within first 3 hours of onset
- Hebra (2012) Intestinal Volvulus, Medscape