# Volvulus

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Twisting of part of the intestine, causing a bowel obstruction

Medical condition

Volvulus Coronal CT of the abdomen, demonstrating a volvulus as indicated by twisting of the bowel stock Specialty General surgery Symptoms Abdominal pain, abdominal bloating, vomiting, constipation, bloody stool[1][2] Complications Ischemic bowel[1] Usual onset Rapid or more gradual[2] Risk factors Intestinal malrotation, enlarged colon, Hirschsprung disease, pregnancy, abdominal adhesions, chronic constipation[1][3] Diagnostic method Medical imaging (plain X-rays, GI series, CT scan)[1] Treatment Sigmoidoscopy, barium enema, bowel resection[3] Frequency 2.5 per 100,000 per year[4][2]

A **volvulus** is a [bowel obstruction](/source/Bowel_obstruction) resulting from a loop of [intestine](/source/Intestine) twisting around itself and its supporting [mesentery](/source/Mesentery).[1] Symptoms include [abdominal pain](/source/Abdominal_pain), [abdominal bloating](/source/Bloating), vomiting, [constipation](/source/Constipation), and [bloody stool](/source/Bloody_stool).[1][2] Onset of symptoms may be rapid or more gradual.[2] The mesentery may become so tightly twisted that [blood](/source/Blood) flow to part of the intestine is cut off, resulting in [ischemic bowel](/source/Mesenteric_ischemia).[1] In this situation there may be [fever](/source/Fever) or [significant pain when the abdomen is touched](/source/Peritonitis).[2]

Risk factors include a [birth defect](/source/Birth_defect) known as [intestinal malrotation](/source/Intestinal_malrotation), an enlarged [colon](/source/Large_intestine), [Hirschsprung disease](/source/Hirschsprung_disease), [pregnancy](/source/Pregnancy), and [abdominal adhesions](/source/Abdominal_adhesion).[1] Long term [constipation](/source/Constipation) and a [high fiber diet](/source/High_fiber_diet) may also increase the risk.[3] The most commonly affected part of the intestines in adults is the [sigmoid colon](/source/Sigmoid_colon), with the [cecum](/source/Cecum) being the second most affected.[1] In children the [small intestine](/source/Small_intestine) is more often involved.[5] The stomach can also be affected.[6] Diagnosis is typically with [medical imaging](/source/Medical_imaging) such as [plain X-rays](/source/Plain_X-ray), a [GI series](/source/Lower_gastrointestinal_series), or [CT scan](/source/CT_scan).[1]

Initial treatment for sigmoid volvulus may occasionally occur via [sigmoidoscopy](/source/Sigmoidoscopy) or with a [barium enema](/source/Barium_enema).[3] Due to the high risk of recurrence, a [bowel resection](/source/Bowel_resection) within the next two days is generally recommended.[3] If the bowel is severely twisted or the blood supply is cut off, immediate surgery is required.[1] In a cecal volvulus, often part of the bowel needs to be surgically removed.[3] If the cecum is still healthy, it may occasionally be returned to a normal position and sutured in place.[1][3]

Cases of volvulus were described in [ancient Egypt](/source/Ancient_Egypt) as early as 1550 BC.[3] It occurs most frequently in Africa, the [Middle East](/source/Middle_East), and India.[3][7][8] Rates of volvulus in the United States are about 2–3 per 100,000 people per year.[2][4] Sigmoid and cecal volvulus typically occurs between the ages of 30 and 70.[1][9] Outcomes are related to whether or not the [bowel tissue has died](/source/Gangrenous).[2] The term volvulus is from the Latin "volvere"; which means "to roll".[3]

## Signs and symptoms

Regardless of cause, volvulus causes symptoms by two mechanisms:[10]

- Bowel obstruction manifested as abdominal distension and bilious vomiting.

- Ischemia (loss of blood flow) to the affected portion of the intestine.

Depending on the location of the volvulus, symptoms may vary. For example, in patients with cecal volvulus, the predominant symptoms may be those of small bowel obstruction (nausea, vomiting, and lack of stool or flatus), because the obstructing point is close to the ileocecal valve and small intestine. In patients with sigmoid volvulus, although abdominal pain may be present, symptoms of constipation may be more prominent.

Volvulus causes severe pain and progressive injury to the intestinal wall, with accumulation of gas and fluid in the portion of the bowel obstructed.[11] Ultimately, this can result in [necrosis](/source/Necrosis) of the affected intestinal wall, [acidosis](/source/Acidosis), and death. This is known as a closed-loop obstruction because there exists an isolated ("closed") loop of bowel. Acute volvulus often requires immediate surgical intervention to untwist the affected segment of bowel and possibly [resect](/source/Bowel_resection) any unsalvageable portion.[11]

Volvulus occurs most frequently in middle-aged and elderly men.[11] Volvulus can also arise as a rare complication in persons with [redundant colon](/source/Large_intestine#Variation), a normal anatomic variation resulting in extra colonic loops.[12]

Sigmoid volvulus is the most common form of volvulus of the gastrointestinal tract.[13] and is responsible for 8% of all intestinal obstructions.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*] Sigmoid volvulus is particularly common in elderly persons and constipated patients. Patients experience abdominal pain, distension, and absolute constipation.

Cecal volvulus is slightly less common than sigmoid volvulus and is associated with symptoms of abdominal pain and small bowel obstruction. It has been associated to several diseases, including [Huntington's disease](/source/Huntington's_disease).[14]

Volvulus can also occur in patients with [Duchenne muscular dystrophy](/source/Duchenne_muscular_dystrophy) due to smooth muscle dysfunction.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

Gastric volvulus causes nausea, vomiting, and pain in the upper abdomen. The Borchardt triad is a group of symptoms that help doctors identify gastric volvulus. The symptoms are intractable retching, pain in the upper abdomen, and inability to pass a nasogastric tube into the stomach.[15]

### Complications

- Strangulation

- [Gangrene](/source/Gangrene)

- [Perforation](/source/Gastrointestinal_perforation)

- Faecal peritonitis

- Recurrent volvulus

## Causes

Midgut volvulus occurs in people (usually babies) who are predisposed because of congenital [intestinal malrotation](/source/Intestinal_malrotation). Segmental volvulus occurs in people of any age, usually with a predisposition because of abnormal intestinal contents (e.g., [meconium ileus](/source/Meconium_ileus)) or [adhesions](/source/Adhesions). Volvulus of the [cecum](/source/Cecum), [transverse colon](/source/Transverse_colon), or [sigmoid colon](/source/Sigmoid_colon) occurs, usually in adults, with only minor predisposing factors such as redundant (excess, inadequately supported) intestinal tissue and constipation.[16]

### Types

- volvulus neonatorum

- Volvulus of the small intestine

- midgut volvulus (due to [intestinal malrotation](/source/Intestinal_malrotation))

- volvulus of the caecum ([cecum](/source/Cecum)), also cecal volvulus

- [sigmoid colon volvulus](/source/Sigmoid_colon_volvulus) (sigmoid volvulus)

- Volvulus of the transverse colon

- volvulus of the splenic flexure, the rarest

- [gastric volvulus](/source/Gastric_volvulus)

- [ileosigmoid knot](/source/Ileosigmoid_knot)

## Diagnosis

After taking a thorough history, the diagnosis of colonic volvulus is usually easily included in the differential diagnosis. Abdominal plain x-rays are commonly confirmatory for a volvulus, especially if a [coffee bean sign](/source/Coffee_bean_sign) is seen. These refer to the shape of the air-filled closed loop of the colon, which forms the volvulus. Should the diagnosis be in doubt, a barium enema may demonstrate a "bird's beak" at the point where the segment of proximal bowel and distal bowel rotate to form the volvulus.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

This area shows an acute and sharp tapering and looks like a bird's beak. If a perforation is suspected, barium should not be used due to its potentially lethal effects when distributed throughout the free intraperitoneal cavity. [Gastrografin](/source/Gastrografin), which is safer, can be substituted for barium.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

The differential diagnosis includes the much more common constricting or obstructing carcinoma. In approximately 80 percent of colonic obstructions, invasive carcinoma is found to be the cause. This is usually easily diagnosed with endoscopic biopsies.

[Diverticulitis](/source/Diverticulitis) is a common condition with different presentations. Although diverticulitis may be the source of a colonic obstruction, it more commonly causes an ileus, which appears to be a colonic obstruction.[17] Endoscopic means can be used to secure a diagnosis, although this may cause a perforation of the inflamed diverticular area. CT scanning is the more common method to diagnose diverticulitis. The scan will show mesenteric stranding in the involved segment of edematous colon, which is usually in the sigmoid region. Microperforations with free air may be seen.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

Ulcerative colitis or [Crohn's disease](/source/Crohn's_disease) may cause colonic obstruction. The obstruction may be acute or chronic, and after years of uncontrolled disease, it leads to the formation of strictures and fistulas. The medical history is helpful in that most cases of inflammatory bowel disease are well known to both the patient and doctor.

Other rare syndromes, including [Ogilvie's syndrome](/source/Ogilvie's_syndrome), chronic constipation, and impaction, may cause a pseudo-obstruction.[18]

- [Abdominal x-ray](/source/Abdominal_x-ray) – tire-like shadow arising from the right iliac fossa and passing to the left

- [Upper GI series](/source/Upper_GI_series)

		- Coffee bean sign in a person with sigmoid volvulus

		- Coronal view of sigmoid volvulus with "whirlpool sign"

		- [CT scan](/source/CT_scan) of a small bowel volvulus. It shows two juxtaposed segments of narrowing, which is the spot of mesentery rotation. The other signs indicate strangulation.

		- An x-ray of a person with a [small bowel](/source/Small_bowel) volvulus.

		- Plain X ray of a cecal volvulus

		- CT scan of a cecal volvulus

## Treatment

Volvulus with gangrene of the sigmoid

### Sigmoid

Treatment for sigmoid volvulus may include sigmoidoscopy. If the mucosa of the sigmoid looks normal and pink, a rectal tube for decompression may be placed, and any fluid, electrolyte, cardiac, kidney, or pulmonary abnormalities should be corrected. The affected person should then be taken to the operating room for surgical repair. If surgery is not performed, there is a high rate of recurrence.[10]

For people with signs of [sepsis](/source/Sepsis) or an abdominal catastrophe, immediate surgery and resection are advised.

### Cecal

In a cecal volvulus, the cecum may be returned to a normal position and sutured in place, a procedure known as cecopexy.[1] If identified early, before presumed intestinal wall ischemia has resulted in tissue breakdown and necrosis, the cecal volvulus can be detorsed laparoscopically.[19]

### Other

[Laparotomy](/source/Laparotomy) for other forms of volvulus, especially anal volvulus.

## References

1. ^ [***a***](#cite_ref-NIH2013_1-0) [***b***](#cite_ref-NIH2013_1-1) [***c***](#cite_ref-NIH2013_1-2) [***d***](#cite_ref-NIH2013_1-3) [***e***](#cite_ref-NIH2013_1-4) [***f***](#cite_ref-NIH2013_1-5) [***g***](#cite_ref-NIH2013_1-6) [***h***](#cite_ref-NIH2013_1-7) [***i***](#cite_ref-NIH2013_1-8) [***j***](#cite_ref-NIH2013_1-9) [***k***](#cite_ref-NIH2013_1-10) [***l***](#cite_ref-NIH2013_1-11) [***m***](#cite_ref-NIH2013_1-12) [***n***](#cite_ref-NIH2013_1-13) ["Anatomic Problems of the Lower GI Tract"](https://web.archive.org/web/20160728003747/https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/anatomic-colon/Pages/facts.aspx#Volvulus). *NIDDK*. July 2013. Archived from [the original](https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/anatomic-colon/Pages/facts.aspx#Volvulus) on 28 July 2016. Retrieved 3 August 2016.

1. ^ [***a***](#cite_ref-Ros2013_2-0) [***b***](#cite_ref-Ros2013_2-1) [***c***](#cite_ref-Ros2013_2-2) [***d***](#cite_ref-Ros2013_2-3) [***e***](#cite_ref-Ros2013_2-4) [***f***](#cite_ref-Ros2013_2-5) [***g***](#cite_ref-Ros2013_2-6) [***h***](#cite_ref-Ros2013_2-7) Marx J, Walls R, Hockberger R (2013). ["95"](https://books.google.com/books?id=uggC0i_jXAsC&pg=RA1-PA74). *Rosen's Emergency Medicine - Concepts and Clinical Practice*. Elsevier Health Sciences. [ISBN](/source/ISBN_(identifier)) [978-1-4557-4987-4](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4557-4987-4). [Archived](https://web.archive.org/web/20160816195750/https://books.google.ca/books?id=uggC0i_jXAsC&pg=RA1-PA74) from the original on 2016-08-16.

1. ^ [***a***](#cite_ref-Gin2012_3-0) [***b***](#cite_ref-Gin2012_3-1) [***c***](#cite_ref-Gin2012_3-2) [***d***](#cite_ref-Gin2012_3-3) [***e***](#cite_ref-Gin2012_3-4) [***f***](#cite_ref-Gin2012_3-5) [***g***](#cite_ref-Gin2012_3-6) [***h***](#cite_ref-Gin2012_3-7) [***i***](#cite_ref-Gin2012_3-8) [***j***](#cite_ref-Gin2012_3-9) Gingold D, Murrell Z (December 2012). ["Management of colonic volvulus"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577612). *Clinics in Colon and Rectal Surgery*. **25** (4): 236–44. [doi](/source/Doi_(identifier)):[10.1055/s-0032-1329535](https://doi.org/10.1055%2Fs-0032-1329535). [PMC](/source/PMC_(identifier)) [3577612](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577612). [PMID](/source/PMID_(identifier)) [24294126](https://pubmed.ncbi.nlm.nih.gov/24294126). The Papyrus Ebers, ca. 1550 BC, described the natural course of volvulus to be spontaneous reduction or "rotting" of the intestines

1. ^ [***a***](#cite_ref-Gor2007_4-0) [***b***](#cite_ref-Gor2007_4-1) Gordon PH, Nivatvongs S (2007). [*Principles and Practice of Surgery for the Colon, Rectum, and Anus, Third Edition*](https://books.google.com/books?id=GEXMBQAAQBAJ&pg=PA971). CRC Press. p. 971. [ISBN](/source/ISBN_(identifier)) [978-1-4200-1799-1](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4200-1799-1). [Archived](https://web.archive.org/web/20160817004842/https://books.google.ca/books?id=GEXMBQAAQBAJ&pg=PA971) from the original on 2016-08-17.

1. **[^](#cite_ref-5)** Wilkins LW (2009). [*Professional Guide to Diseases*](https://archive.org/details/isbn_9780781778992). Lippincott Williams & Wilkins. p. [283](https://archive.org/details/isbn_9780781778992/page/283). [ISBN](/source/ISBN_(identifier)) [978-0-7817-7899-2](https://en.wikipedia.org/wiki/Special:BookSources/978-0-7817-7899-2).

1. **[^](#cite_ref-6)** Feldman M, Friedman LS, Brandt LJ (2010). [*Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management, Expert Consult Premium Edition - Enhanced Online Features*](https://books.google.com/books?id=zEZOqB6r9hwC&pg=PA384) (9 ed.). Elsevier Health Sciences. p. 384. [ISBN](/source/ISBN_(identifier)) [978-1-4377-2767-8](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4377-2767-8). [Archived](https://web.archive.org/web/20160816210234/https://books.google.ca/books?id=zEZOqB6r9hwC&pg=PA384) from the original on 2016-08-16.

1. **[^](#cite_ref-7)** Brothwell DR, R DW, Sandison AT (14 May 2014). [*Diseases in Antiquity: A Survey of the Diseases, Injuries, and Surgery of Early Populations*](https://books.google.com/books?id=CFd7nQAACAAJ). Charles C. Thomas Publisher, Limited. [ISBN](/source/ISBN_(identifier)) [978-0-398-08909-2](https://en.wikipedia.org/wiki/Special:BookSources/978-0-398-08909-2).

1. **[^](#cite_ref-8)** Ballantyne GH (July 1982). "Review of sigmoid volvulus: History and results of treatment". *Diseases of the Colon & Rectum*. **25** (5): 494–501. [doi](/source/Doi_(identifier)):[10.1007/BF02553666](https://doi.org/10.1007%2FBF02553666). [PMID](/source/PMID_(identifier)) [7047106](https://pubmed.ncbi.nlm.nih.gov/7047106). [S2CID](/source/S2CID_(identifier)) [37405850](https://api.semanticscholar.org/CorpusID:37405850).

1. **[^](#cite_ref-9)** Beck D, Beck DE (2012). ["23"](https://books.google.com/books?id=yJbXNf0XKysC&pg=PT454). *Handbook of Colorectal Surgery: Third Edition*. JP Medical Ltd. [ISBN](/source/ISBN_(identifier)) [978-1-907816-20-8](https://en.wikipedia.org/wiki/Special:BookSources/978-1-907816-20-8). [Archived](https://web.archive.org/web/20160816222554/https://books.google.ca/books?id=yJbXNf0XKysC&pg=PT454) from the original on 2016-08-16.

1. ^ [***a***](#cite_ref-auto_10-0) [***b***](#cite_ref-auto_10-1) ["Volvulus"](https://www.lecturio.com/concepts/volvulus/). *The Lecturio Medical Concept Library*. Retrieved 12 July 2021.

1. ^ [***a***](#cite_ref-MTS_11-0) [***b***](#cite_ref-MTS_11-1) [***c***](#cite_ref-MTS_11-2) Wedding, Mary Ellen, Gylys, Barbara A. (2004). *Medical Terminology Systems: A Body Systems Approach (Medical Terminology (W/CD & CD-ROM) (Davis))*. Philadelphia, Pa: F. A. Davis Company. [ISBN](/source/ISBN_(identifier)) [0-8036-1249-4](https://en.wikipedia.org/wiki/Special:BookSources/0-8036-1249-4).

1. **[^](#cite_ref-12)** Mayo Clinic Staff (2006-10-13). ["Redundant colon: A health concern?"](https://web.archive.org/web/20070929110621/http://www.mayoclinic.com/health/redundant-colon/AN00239/rss%3D1). *Ask a Digestive System Specialist*. MayoClinic.com. Archived from [the original](http://www.mayoclinic.com/health/redundant-colon/AN00239/rss=1) on 2007-09-29. Retrieved 2007-06-11.

1. **[^](#cite_ref-pmid14971995_13-0)** Turan M, Sen M, Karadayi K, et al. (January 2004). ["Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process"](http://www.grupoaran.com/mrmUpdate/lecturaPDFfromXML.asp?IdArt=456022&TO=RVN&Eng=1). *Rev Esp Enferm Dig*. **96** (1): 32–5. [doi](/source/Doi_(identifier)):[10.4321/s1130-01082004000100005](https://doi.org/10.4321%2Fs1130-01082004000100005). [PMID](/source/PMID_(identifier)) [14971995](https://pubmed.ncbi.nlm.nih.gov/14971995). [Archived](https://web.archive.org/web/20110711132044/http://www.grupoaran.com/mrmUpdate/lecturaPDFfromXML.asp?IdArt=456022&TO=RVN&Eng=1) from the original on 2011-07-11.

1. **[^](#cite_ref-14)** Ferrer-Inaebnit E, Segura-Sampedro JJ, Molina-Romero FX, González-Argenté X (October 2020). "Oclusión e isquemia por vólvulo de ciego en corea de Huntington". *Gastroenterología y Hepatología* (in Spanish). **43** (10): 633–634. [doi](/source/Doi_(identifier)):[10.1016/j.gastrohep.2020.03.005](https://doi.org/10.1016%2Fj.gastrohep.2020.03.005). [PMID](/source/PMID_(identifier)) [33051047](https://pubmed.ncbi.nlm.nih.gov/33051047). [S2CID](/source/S2CID_(identifier)) [241550167](https://api.semanticscholar.org/CorpusID:241550167).

1. **[^](#cite_ref-15)** Peterson CM, Anderson JS, Hara AK, Carenza JW, Menias CO (September 2009). ["Volvulus of the Gastrointestinal Tract: Appearances at Multimodality Imaging"](http://pubs.rsna.org/doi/10.1148/rg.295095011). *RadioGraphics*. **29** (5): 1281–1293. [doi](/source/Doi_(identifier)):[10.1148/rg.295095011](https://doi.org/10.1148%2Frg.295095011). [ISSN](/source/ISSN_(identifier)) [0271-5333](https://search.worldcat.org/issn/0271-5333). [PMID](/source/PMID_(identifier)) [19755596](https://pubmed.ncbi.nlm.nih.gov/19755596).

1. **[^](#cite_ref-16)** Le CK, Nahirniak P, Anand S, Cooper W (2023). ["Volvulus"](https://www.ncbi.nlm.nih.gov/books/NBK441836/). *National Center for Biotechnology Information, U.S. National Library of Medicine*. [PMID](/source/PMID_(identifier)) [28722866](https://pubmed.ncbi.nlm.nih.gov/28722866). Retrieved 12 July 2021.

1. **[^](#cite_ref-17)** Hoffman, Gary H. (2007-08-16). ["Diverticulosis/Diverticulitis - For Physicians"](http://www.lacolon.com/patient-education/diverticulosis-and-diverticulitis). *Time To Call The Surgeon?*. [Los Angeles Colon and Rectal Surgical Associates](https://en.wikipedia.org/w/index.php?title=Los_Angeles_Colon_and_Rectal_Surgical_Associates&action=edit&redlink=1). LAcolon.com. [Archived](https://web.archive.org/web/20130226052507/http://www.lacolon.com/patient-education/diverticulosis-and-diverticulitis) from the original on 2013-02-26. Retrieved 2012-07-07.

1. **[^](#cite_ref-18)** Hoffman, Gary H. (2009-10-27). ["What is Constipation?"](http://www.lacolon.com/conditions/constipation). *What Can Be Done About Constipation*. Los Angeles Colon and Rectal Surgical Associates. LAcolon.com. [Archived](https://web.archive.org/web/20120613193637/http://www.lacolon.com/conditions/constipation) from the original on 2012-06-13. Retrieved 2012-07-06.

1. **[^](#cite_ref-19)** Jones RG, Wayne EJ, Kehdy FJ (May 2012). ["Laparoscopic detorsion and cecopexy for treatment of cecal volvulus"](https://doi.org/10.1177%2F000313481207800503). *The American Surgeon*. **78** (5): E251–252. [doi](/source/Doi_(identifier)):[10.1177/000313481207800503](https://doi.org/10.1177%2F000313481207800503). [ISSN](/source/ISSN_(identifier)) [1555-9823](https://search.worldcat.org/issn/1555-9823). [PMID](/source/PMID_(identifier)) [22546094](https://pubmed.ncbi.nlm.nih.gov/22546094). [S2CID](/source/S2CID_(identifier)) [5812146](https://api.semanticscholar.org/CorpusID:5812146).

## External links

Wikimedia Commons has media related to [Volvulus](https://commons.wikimedia.org/wiki/Category:Volvulus).

Classification D ICD-10: K56.2 ICD-9-CM: 537.3, 560.2 MeSH: D045822 DiseasesDB: 13996 External resources eMedicine: ped/2415

- [CT of an abdomen with sigmoid volvulus](http://www.claripacs.com/case/CL0013)

v t e Diseases of the human digestive system Upper GI tract Esophagus Esophagitis Candidal Eosinophilic Herpetiform Rupture Boerhaave syndrome Mallory–Weiss syndrome Zenker's diverticulum Barrett's esophagus Esophageal motility disorder Nutcracker esophagus Achalasia Esophagogastric junction outflow obstruction Diffuse esophageal spasm Gastroesophageal reflux disease (GERD) Laryngopharyngeal reflux (LPR) Esophageal stricture Inlet patch Megaesophagus Esophageal intramural pseudodiverticulosis Acute esophageal necrosis Stomach Gastritis Atrophic Ménétrier's disease Gastroenteritis Peptic (gastric) ulcer Cushing ulcer Dieulafoy's lesion Dyspepsia Functional dyspepsia Pyloric stenosis Achlorhydria Gastroparesis Gastroptosis Portal hypertensive gastropathy Gastric antral vascular ectasia Gastric dumping syndrome Gastric volvulus Buried bumper syndrome Gastrinoma Zollinger–Ellison syndrome Lower GI tract Enteropathy Small intestine (Duodenum/Jejunum/Ileum) Enteritis Duodenitis Jejunitis Ileitis Peptic (duodenal) ulcer Curling's ulcer Malabsorption: Coeliac Tropical sprue Blind loop syndrome Small intestinal bacterial overgrowth Whipple's Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption Large intestine (Appendix/Colon) Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Dysentery Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis/Diverticulosis/SCAD Large and/or small Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn's disease Vascular: Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction: Ileus Intussusception Volvulus Fecal impaction Constipation Functional Diarrhea Infectious Intestinal adhesions Rectum Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse (Internal rectal prolapse) Anismus Solitary rectal ulcer syndrome Rectal stricture Anal canal Anal fissure/Anal fistula Anal abscess Hemorrhoid Anal dysplasia Pruritus ani Anal stricture GI bleeding Blood in stool Upper Hematemesis Melena Lower Hematochezia Accessory Liver Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver MASLD Vascular Budd–Chiari syndrome Hepatic veno-occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson's disease Hemochromatosis Gallbladder Cholecystitis Gallstone / Cholelithiasis Cholesterolosis Adenomyomatosis Postcholecystectomy syndrome Porcelain gallbladder Bile duct/ Other biliary tree Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis/Mirizzi's syndrome Biliary fistula Haemobilia Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction Pancreatic Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula Other Hernia Diaphragmatic Congenital Hiatus Inguinal Indirect Direct Umbilical Paraumbilical Femoral Obturator Spigelian Lumbar Petit's Grynfeltt–Lesshaft Undefined location Incisional Internal hernia Richter's Peritoneal Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum

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