Maftuhah Zahara
Definisi
Organo axial
Sigmoid
Mesentero Axial
Volvulus Colon
Axial
Caecal
Bascule
Etiology
Volvulus sigmoid mesenterium yg panjang (A) dengan basis yang sempit (B)
Diagnosis
Nyeri kolik
Di antara kolik terdapat nyeri perut menetap
Perut sangat membesar karena distensi
Kadang terdapat mual muntah
Gambaran foto rontgen :
dilatasi sigmoid coffee bean
dengan barium, rektal terlihat tanda paruh burung
(bird’s beak sign)
Perbedaan Volvolus Colon Sigmoid dan Caecal
arises in the pelvis (left lower quadrant) arises in the right lower quadrant
extends towards the right upper quadrant extends towards the epigastrium or left upper
ahaustral in appearance quadrant
colonic haustral pattern is maintained
sigmoid volvulus causes obstruction of the
proximal large bowel, therefore the ascending, distal colon is usually collapsed and the small
transverse and descending colon may be dilated bowel is distended
few air-fluid levels may be seen one air-fluid level may be seen
Gambaran Radiologi
Pada foto polos abdomen nampak gambaran biji kopi (coffee bean sign)
Pada CT Scan nampak pola pusaran (whirled pattern) yang terbentuk dari
lengkungan aferen dan efferen usus yang berputar
Plain radiograph sigmoid colon volvulus
Frimann-Dahl sign-
three dense lines converge
towards the site of
obstruction
CT-Scan