Volvulus

Although the incidence of sigmoid volvulus is rare in Western countries, it is one of the most common causes of emergency large-bowel surgery in other countries, particularly in Africa. In the UK, sigmoid volvulus often occurs in elderly and frail patients. The clinical symptoms and signs are those of colonic obstruction, often the abdomen is hugely distended and 'drum-like' and the rectum is empty on digital examination. The diagnosis is supported by a typical X-ray appearance. In the absence of signs of peritonitis, detorsion of the volvulus can be attempted by use of a rigid sigmoido-scope and a flatus tube; however, flexible sigmoidoscopy may be more effective. If colonic ischaemia is suspected, then prompt laparotomy is indicated. Recurrence rates after

Figure 13.1. (a) Rectal cancer viewed at endoscopy and (b) transrectal ultrasound. Cancer (labelled A) arising at anorectal junction seen at endoscopy (retroflex manoeuvre) and same cancer at endorectal ultrasound. The muscularis propria lesion is seen within the bowel wall. This layer is lost at C indicating local invasion and the tumour was staged as T3.

Figure 13.1. (a) Rectal cancer viewed at endoscopy and (b) transrectal ultrasound. Cancer (labelled A) arising at anorectal junction seen at endoscopy (retroflex manoeuvre) and same cancer at endorectal ultrasound. The muscularis propria lesion is seen within the bowel wall. This layer is lost at C indicating local invasion and the tumour was staged as T3.

Table 13.1. Indications for lower GI endoscopy.

Colonoscopy

Flexible sigmoidoscopy

Dark red rectal bleeding

Bright red rectal bleeding

Iron deficiency anaemia

Left-sided abnormalities on other

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment