Clinical features
The patient with sigmoid volvulus is generally elderly with a long history of constipation and use of laxatives. Note also that this condition has a higher incidence in long stay patients in mental hospitals who have a prolonged history of tranquiliser usage.
Clinical features include:
- marked abdominal distension
- sudden onset of colicky pain
- absolute constipation and no passage flatus for at least 24 hours
- may be history of previous episodes - colonic twists may spontaneously untwist
- on examination:
- abdomen is distended and tympanic
- left ilac fossa tenderness
- rectal examination reveals a capacious, empty rectum
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