Disorders of the Gastrointestinal System, 2nd Edition
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Volvulus Volvulus is a twisting of the stomach or intestine on its mesentery, a fold of tissue that attaches the intestine to the back of the abdominal wall, resulting in acute or chronic obstructions and potential isch- emia (Hodin, 2022). The sigmoid colon and cecum are the most commonly af- fected areas. Volvulus may be caused by an abnormality of rotation, malignancy or mass, comorbid diseases, abdominal ad- hesion, and more. The condition is most commonly linked to chronic constipation and a diet too high in fiber. It can overload susceptible parts of the colon and lead to pulling and twisting above and below the affected area. Patients with Parkinson’s disease, spinal cord injury, and multiple sclerosis are at higher risk because of medications and neuromuscular changes. Crohn’s disease also places a patient at higher risk (Thornton, 2022).
CASE STUDY 14 David is a 45-year-old electrician. He has just spent a relaxing Sunday with his wife, daughter, and son. They enjoyed watching his daughter play in her first soccer tournament and celebrated her team’s victory with dinner at their favor- ite restaurant. Later that evening, David suddenly developed episodes of vomit- ing and abdominal distention. He blames it on “something I ate” at the restaurant. However, he soon experiences an abrupt onset of severe abdominal pain. His wife insists on taking him to the emergency department, where diagnostic studies in- dicate a severe bowel problem, possibly volvulus. Question David asked his nurse to explain what a volvulus is. Which of the definitions should the nurse provide? a. When a section of the intestine slides inside a nearby part. b. GI motility is slowed down or doesn’t work at all. c. A twisting of the stomach or intestine on where they attach to the abdominal wall. d. Absent or low production of hydrochloric acid in gastric secretions of the stomach and other digestive organs. Answer/Rationale: The correct answer is c. Volvulus is a twisting of the stomach or intestine on its mesentery, a fold of tissue that attaches the intestine to the back of the abdominal wall, resulting in acute or chronic obstructions and potential ischemia.
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