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Transverse Colon Volvulus

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Volvulus is rotation of part of the intestine around its mesentry, causing a intestinal obstruction. Colonic volvulus is not common cause of intestinal obstruction in the developed world. However much more common in the developing world (6,7). High prevalence of volvulus are reported in the “Volvulus Belt” of Africa, the Middle East, India, and Russia. In these regions, the average age is younger than Western countries, ranging from 40 to 50 years and in generally better health (8). In the United States, colonic volvulus accounts for 10 to 15% of all colon obstructions(9). The sigmoid colon is most common site followed by caecum for volvulus. Transverse colon volvulus is an uncommon cause of intestinal obstruction. Literature …show more content…

Twisting of bowel commonly occurs along the mesenteric axis , resulting in venous obstruction and eventually arterial compromise. Redundancy and non-fixation of bowel are essential to form any type of volvulus. The ascending and descending segments of the colon are not mobile , but the sigmoid colon, caecum, and transverse colon are not fixed within the peritoneum, tethered by their mesentery. This mobility contributes volvulus to occur at these locations. Thirty three to thirty five percent of patients with volvulus of the transverse colon appear to have had a history of chronic constipation which is either idiopathic or secondary to autonomic dysfunction (5) . In our patient chronic constipations , laxative abuse and high fibre diet may be contributing for the transverse colon volvulus . These conditions may predispose the elongation and chronic redundancy of the colon and its mesentry, which favoure it to rotation. In our part of world , most of people are farmer and they eat high fibre content diet, that may be reason for high incidence of volvulus. Honestely , it is difficult to conclude the broad conclusions regarding the incidence of transverse colon volvulus in the adult population due to the relatively small number of reported cases. Therefore, surgeon should be aware of these unusal causes of large bowel obstruction to allow for early diagnosis and to facilitate better patient

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