VOLVULUS, v61'14-lils (Latin volvo, I roll or twist): in medicine, term denoting a twisting of the intestine, producing obstruction to the passage of its contents. A disorder of a different kind, but with similar symptoms and often similar results, is Intussusception (q.v.). There are three distinct varieties of rotatory movement capable of giving rise to volvulus — (1) A portion of intestine may have become twisted on its own axis, and in that case even semi-rotation brings the intestinal walls into con tact, so as to close the passage: this is a rare condition, occurring only in the ascending colon. (2) The mesentery (q.v.), or a part of it, may be. twisted into a cone, dragging the intestine with it; the mesentery being the axis, and the intestine being rolled up on it; this form occurs in the small intestine. (3) a single por tion or a coil of intestine may afford the axis round which another portion with its mesentery is thrown, so as to compress it, and close the passage. A coil of small intestine, the sigmoid flexure or the cmcum (see DIGESTION), may form the axis. All these varieties occur chiefly in advanced life, and their seat is commonly toward the posterior unyielding wall of the abdominal cavity, the smoothness and yieldinv nature of the parts anteriorly render ing such an event almost impossible. The symptoms of twisting of the intestine, especially of the sigmoid flexure, the most common seat of the affection, are usually distinctly marked from the beginning. Great pain is suddenly experienced in a small circumscribed spot of the abdomen, obstinate constipation usually set ting in from that date. If the sigmoid flexure,
which lies just above the rectum. is the seat of the twisting, the abdomen soon becomes dis tended, especially on the left side, the disten tion being much more marked than when the twist is in the small intestine, as might physio logically have been expected. Vorruting, often constant and copious, is 'usually present. These cases are so desperate in their nature that it is needless to enlarge on their treatment. At tempts to remove the displacement by inject ing water or air into the intestine through a long tube have often been made, but with slight success. Operations for relief of this and other intestinal obstructions, e.g., intussuscep tion, have until recently been very often fatal ; but of late the progress of surgery —especially in connection with antiseptics—has greatly re duced the ratio of fatal results. Intestinal ob structions produced either by Volvulus or by other causes have been successfully treated by surgical means; diseased portions of. the in testine (e.g., the appendix verrraformis) have been cut out and the separated parts reumted by sewing (enterorrhaphia). In the treatment a few rules are universally applicable, viz., wherever symptoms such as aoove descnbed oc cur, aperients should be given only .by the rectum, while opium should be freely given by the mouth. Leeches and hot fomentations should be applied to the seat of pain, and all solid food should be ,prohibited, the nourish ment being given solely in fluid form.