When this occurs. part of the bowel twists on itself. The result is that the blood supply is suddenly cut off. This gains access to the bowel via the mesentery, a sheet of thin tissue that provides the bowel with its nutritional requirements. When this occurs, a closed-loop type of obstruction takes place. The immediate risk is that if complete, the bowel, devoid of its blood supply, may quickly die and become gangrenous and perforate. Peritonitis may quickly follow. Often the volvulus is not complete, and cases occur where it tends to come and go.
Sometimes symptoms come on rapidly, or they may be much slower. Symptoms simulate a bowel obstruction.
Acute cases must be surgically treated as an emergency. For chronic forms, more probable with older adults, decompression by a rectal tube may be possible. However, this again is in the province of the doctor, and any symptoms that indicate abdominal problems must receive prompt, expert medical attention. Delay may prove fatal.
One of the major changes in surgical care in recent years is the day-care centres. Here, the patient is admitted for one day (or part of a day) only. Many one-time major surgical operations have contracted to fairly “minor” procedures that can be completed in a short time.
With quick-acting general anaesthetics (or the use of local anaesthesia), a large amount of investigation and treatment can be quickly and expertly carried out. Theatres are often attached to the centres, with certain theatres being geared for a small, specific range of operations (eg endoscopic or colonoscopic surgery, eye surgery, various gynaecological or abdominal laparoscopic techniques). This not only reduces overall costs, but enables more patients to be treated in a shorter time. It appears to be the way of the future.