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The large intestine is attached to the posterior abdominal wall by a ligament called the mesentery. The mesentery contains vessels that provide blood supply to the large intestine as well as fatty tissue. Since the ascending and descending colon parts of the large intestine are covered by the peritoneum, the mesenteries of these sections are not free, but since the transverse colon and sigmoid colon move freely in the abdomen, their mesenteries are also free. Especially the mesentery of the sigmoid colon is long.


The twisting of the mesentery around itself is called volvulus. It is most commonly seen in the sigmoid colon. It causes both obstruction in the intestinal passage and disruption of blood flow in the tissues due to the compression of blood vessels. Patients usually apply to the Emergency Service with complaints of inability to pass gas and stool, bloating and pain in the abdomen.


The diagnosis of volvulus is made by abdominal X-ray and computed tomography. After the diagnosis is made, it should be treated without losing time. Due to the deterioration of blood flow in the tissues, the mesentery, which has turned into an auger around the genital area, is corrected with the help of a colonoscope placed from the anus, and normal stool and blood flow is ensured. If this is not possible, the rotated large intestine is surgically removed, and the remaining end is most likely mouthed to the abdominal wall and taken into the bag. This is almost always a temporary bag. After the disease is healed and the general condition of the patient recovers, intestinal continuity is ensured with a new surgery within a few months.

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