Large Colon
Volvulus
Basic Information 
Definition
Rotation of the colon around the mesenteric axis (which is also the long axis of the large colon)
Clinical Presentation
Physical Exam Findings
• Physical examination findings depend on the duration and degree of colonic compromise and distension. Initially, because of the very acute nature of the disease, physical examination may reveal normal vital signs, decreased to absent borborygmi, and severe pain.
• As distension progresses, respiratory and cardiovascular collapse may result.
• As endotoxemia occurs, compromise to the cardiovascular system worsens. Physical examination reveals signs of hypovolemic or endotoxemic (maldistributive) shock, including hyperemic or toxic mucous membranes, prolonged or decreased capillary refill time, poor pulse quality, cold extremities, and decreased jugular refill.
Etiology and Pathophysiology
• It is possible that, similar to large colon displacements, changes in motility or distension of the large colon result in abnormal migration of the colon.
• Because of the increased incidence in postpartum mares, some have suggested that a sudden increase in the volume available for the colon to occupy plays a role in the development of large colon volvulus.
• The most common location for large colon volvulus is at the level of the cecocolic ligament. Less frequently, volvulus may include the cecum or occur at the level of the sternal-diaphragmatic flexure.
• The direction of the large colon volvulus is almost always with the ventral colon rotating dorsomedially (counterclockwise when viewed from a ventral midline incision), but rotation in the other direction may also occur.
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