Volvulus is a childhood condition that causes twisting of the intestine leading to obstruction in the flow of the contents of the digestive tract as well as blockage of blood to the intestine itself.
Abnormal twisting of the intestine is a dangerous condition and is usually treated as an emergency condition. If left untreated, it could lead to intestinal obstruction, perforation of the intestine, peritonitis, gangrene as well as the death of the intestinal cells.
The intestine tends to twist on itself and it usually occurs due to a birth defect called malrotation. This occurs during the fetal development when the bowel is misaligned. If volvulus occurs in association with malrotation, it shows symptoms within the first year itself in most cases.
Signs and Symptoms
Symptoms of volvulus usually occur suddenly and the child has to be rushed to an emergency ward. In some children, the condition causes recurrent episodes of vomiting. This happens along with abdominal pain and which may disappear on its own. It is called as ‘intermittent volvulus’ that occurs when the bowel twists and untwist on its own.
Symptoms of volvulus are similar to bowel obstruction and include:
- Abdominal tenderness
- Vomiting green bile
- Constipation or problems expelling stools
- Distended abdomen
- Blood or dark red stools
- Bowel obstruction
- Accumulation of gas and fluid in the part of bowel obstruction
- Necrosis of the affected intestinal wall, acidosis and cell death
Most of the cases of volvulus usually infants are due congenital intestinal malrotation. In cases of segmental volvulus the condition occurs due to underlying conditions such as meconium ileus or adhesions. In case of adults, the condition occurs in case of predisposing factors such as constipation or redundant intestinal tissues.
Volvulus is diagnosed on the basis of the following tests:
- Abdominal x-rays that show a bent inner tube or a typical ‘coffee bean’ sign
- Any doubt about the x-ray can be cleared with the help of a barium enema that will reveal a ‘bird’s beak’ at the point where the segment of proximal bowel and distal bowel rotate and form the volvulus.
- In case perforation in the intestine is suspected, use of gastrografin over barium is preferred.
- Stool sample that shows blood in stool
- CT scan that shows evidence of intestinal obstruction
The treatment involves surgery to repair the volvulus. The twisted bowels are untwisted and the blood supply restored. In case of necrosis of a segment of bowel, it is removed and the healthy ends are sewn back together. In some cases, the surgeon will perform colostomy or ileostomy.
In case of severe necrosis of the bowel, it will require an entire removal of the intestines. In this situation the prognosis is very poor and may even lead to fatal consequences.
Complications due to volvulus include secondary peritonitis or short bowel syndrome. Volvulus is a serious condition in children that can lead to many complications. However, surgery usually helps children recover and live a healthy life. Visit a doctor immediately if any of the symptoms are observed and seek timely medical intervention.
Written by: healthplus24.com team
Date last updated: January 30, 2015