When the body develops from its embryological form the tissues that form the gut must rotate to form the proper position of the intestinal tract. If it doesn’t rotate fully, this is called a malrotation and could lead to a volvulus.
Definition of a Volvulus
A volvulus is a twisting of the small or large intestine. This has the potential to lead to a bowel obstruction and dead bowel.
Anatomy of a Volvulus
A volvulus is far more common in children than adults and develops due to malrotation of the gut. When the gut is forming, the gut needs to rotate 75 percent around itself to properly form. If it doesn’t rotate, this is called malrotation. This malrotation causes the gut to twist on itself and leads to an obstruction. Although this congenital issue is more common in children, adults can develop an acquired volvulus, especially of the colon. In adults, this is a medical emergency.
Causes of a Volvulus
The most common cause of a volvulus is malrotation. The other secondary causes that lead to a volvulus in adults include redundant tissue, severe constipation that stretches the gut, and tumors.
Symptoms of a Volvulus
The symptoms of a volvulus usually start with pain. Adults will often notice abdominal distension with an inability to pass gas or stool.
Diagnosis of a Volvulus
The diagnosis always starts with a history and physical exam. If a volvulus is suspected, the physician will order an abdominal x-ray. Barium enemas were often used to help with this diagnosis. However, due to availability and ease, computed tomography tends to be the imaging of choice.
Prevention of a Volvulus
In adults, eating a healthy diet and preventing constipation can lessen the chances of a secondary volvulus developing from constipation.
Am I At Risk for a Volvulus?
Children with malrotation are at risk for developing a volvulus. Patients with severe, longstanding constipation are also at risk.
Treatment of a Volvulus
A volvulus is a serious condition that requires surgical intervention. In adults, this usually results in a partial colon resection or occasionally a small bowel resection.
To learn more about treatment procedures for this condition please visit the following:
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