Sigmoid volvulus anyone?

core0 · Aug 21, 2009

Ran into my first patient with a Sigmoid Volvulus.... The CT findings were a surprise to both me and supervising MD. Not elderly, abdominal pain diffuse nonspecific mild, no distention, recurrent complaints of constipation.
Had a recorded weight loss of 60 lbs in one year on initial presentation.
Anyone have experience with this??

I saw a lot in Colorado. For some reason they are more common at high altitude. When you have the weight loss also I would be concerned for colon cancer.

http://emedicine.medscape.com/article/373585-overview

David Carpenter, PA-C

JDCitizen · Aug 21, 2009

I saw a lot in Colorado. For some reason they are more common at high altitude. When you have the weight loss also I would be concerned for colon cancer.
http://emedicine.medscape.com/article/373585-overview
David Carpenter, PA-C

Exactly the same article I pulled up to do some reading. CA is still on our radar.

Sheri FNP-C · Aug 22, 2009

Stool for O&P? and of course CA as David mentioned. Interesting, let us know!

JDCitizen · Aug 22, 2009

Stool for O&P? and of course CA as David mentioned. Interesting, let us know!

Labs were normal.... Surgical consult is in. Plan to talk some more with patient this week.

I_LOVE_TRAUMA, RN · Aug 22, 2009

Our surgeons almost always attempt to reverse with colonoscopy now, works many times, very interesting..

JDCitizen · Sep 11, 2009

Our surgeons almost always attempt to reverse with colonoscopy now, works many times, very interesting..

Sorry for the delay at getting back:

They do want to do a colonoscopy but they want him to be completely cleaned out; and I mean completely:

Two days of clear liquids

Daily Miralax

Daily Mineral oil

1/2 bottle of mag citrate daily x2

the day before the colonoscopy:

Clear liquids

golytley (bad name for this prep)

enema

You can bet we are keeping and eye on those electrolytes :-)