A close-up of the anastomosis is shown, with the reinforcing stitch at the crotch. The abdomen was copiously lavaged with warm saline and closed in standard fashion.
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The portions of the colon that are not fixed to the parietal peritoneum, the sigmoid, transverse, and to a variable degree the cecum, have the potential to twist, kink their blood supply and create closed loop obstructions. Patients with large redundant colons are at higher risk for such events. Displacement of the colon during pregnancy is also a risk factor. Most (85%) volvulus involves the sigmoid, the next most common being the cecum, and rarely the transverse colon (because of the widely separated ends).
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