Other nonneoplastic


Topic Completed: 19 February 2021

Minor changes: 25 February 2021

Copyright: 2003-2021,, Inc.

PubMed Search: volvulus [title] colon [title] pathology

Raul S. Gonzalez, M.D.
Page views in 2020: 2,762
Page views in 2021 to date: 3,029
Cite this page: Gonzalez RS. Volvulus. website. Accessed October 25th, 2021.
Definition / general
  • Complete twisting of loop of bowel around its mesenteric base of attachment, causing obstruction and infarction
Essential features
  • Clinical torsion of colon leading to colonic necrosis
  • High mortality rate
  • Also called torsion (volvulus is a more specific term referring to gastrointestinal torsion)
  • Potentially due to adhesions from prior surgery
Clinical features
  • More common in men
  • Patients typically demonstrate abdominal pain, distension, hyperactive bowel sounds
  • High rate of mortality, particularly in older patients (Eur Rev Med Pharmacol Sci 2013;17:127)
Radiology description
  • Dilated loops of intestine
  • Volvulus may be visible on CT
Radiology images

Images hosted on other servers:

Volvulus as seen on CT

Case reports
  • 16 year old boy with sigmoid volvulus with an associated anomalous congenital band (Am Surg 2013;79:1140)
Gross description
Microscopic (histologic) description
  • Colon may be ischemic or gangrenous
Sample pathology report
  • Cecum and ascending colon, resection:
    • Segment of colon with patchy transmural necrosis and serosal adhesions (see comment)
    • Necrosis extends to distal resection margin; proximal margin unremarkable.
    • Four benign lymph nodes.
    • Comment: The findings are consistent with the clinical impression of volvulus as reported in the operative note.
Board review style question #1
Which of the following is true about volvulus of the colon?

  1. It can only be identified via surgical exploration
  2. It has a low rate of morbidity / mortality
  3. The affected colon appears normal microscopically
  4. The cecum is a common site
Board review style answer #1
D. The cecum is a common site

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Reference: Volvulus
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