Volvulus physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Patients with volvulus usually appear in distress. Vital signs may demonstrate tachycardia and low grade fever. Physical examination of patients with volvulus is usually remarkable for abdominal distention and abdominal tenderness.

Patients with volvulus usually appear in distress.^[1][2][3]

• Low-grade fever
• Tachycardia with regular pulse
• Tachypnea
• Low blood pressure with narrow pulse pressure, in the case of hypovolemic shock with bowel perforation

In the case of gastric volvulus when the stomach may be displaced into the chest cavity, the patient may present with stridor.

• Orthostatic hypotension may be present
• Severe distension may lead to cardiogenic shock.

• Abdominal distention and tympany
  • May be severe and cause cardiovascular and respiratory symptoms
• Abdominal tenderness
  • May indicate peritonitis
• Rebound tenderness (positive Blumberg sign)
  • May indicate peritonitis
• A palpable abdominal mass in the right/left upper/lower abdominal quadrant
• Guarding may be present
• Empty left iliac fossa
  • May indicate sigmoid volvulus
    

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