Question
A patient presented with complain of abdominal pain,distension and absolute constipation.Abdominal X ray shows the following features.What can be the most probable diagnosis?
A. Colitis.
B. Paralytic Ileus.
C. Sigmoid Volvulus.
D. Cecal Volvulus.
Show Answer
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Correct Answer » C
Explanation
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Ans:C. Sigmoid Volvulus.
Abdominal X ray in the image shows the features of Sigmoid Volvulus
- The sigmoid colon is very dilated because it is twisted at the root of its mesentery in the left iliac fossa (LIF). The proximal large bowel is also dilated .
- The twisted loop of sigmoid colon is said to resemble a coffee bean.(marked by red dots) .
Twisting of the bowel – or ‘volvulus’ – is a specific cause of bowel obstruction.
- The two commonest types of bowel twisting are sigmoid volvulus and caecal volvulus.
Sigmoid volvulus
- The sigmoid colon is more prone to twisting than other segments of the large bowel because it is ‘mobile’ on its own mesentery, which arises from a fixed point in the left iliac fossa (LIF).
- Twisting at the root of the mesentery results in the formation of an enclosed loop of sigmoid colon which becomes very dilated.
- If untreated this can lead either to perforation, due to excessive dilatation, or to ischaemia due to compromise of the blood supply.
