Volvulus is a condition where part of the intestine folds over and loops around itself. It usually occurs in the sigmoid and cecal parts of the intestines. The twisting cuts off the blood supply, causing symptoms such as bloody stool, bowel obstruction, and severe pain. Volvulus can result in bowel perforation or tissue death (necrosis), which can be life-threatening.
Understanding Colonic Volvulus
Individuals with health conditions and those between 50 and 80 have the highest risk of developing volvulus. In some cases, the condition can be congenital. Intestinal malrotation can occur at birth as the intestines fail to develop properly. It can put children at risk of developing volvulus, usually in the small intestines.
Unfortunately, most infants with the condition require the removal of the damaged section of the intestine. It can lead to short bowel syndrome (SBS), where children are unable to absorb nutrients adequately.
What Causes Volvulus?
What causes volvulus is unclear, but it usually occurs in senior adults. Studies show it is more common in people with underlying psychiatric or neurologic conditions. It is prevalent among individuals in senior care who spend most of their time in bed.
Factors that can increase the risk of the condition include chronic constipation, past abdominal surgery, and a high-fiber diet. Individuals with specific anatomic features, such as a long, twisted sigmoid colon, have a high risk of developing volvulus. If the colon fails to move as it should, it can twist more easily.
Warning Signs of Volvulus
In most cases, symptoms of volvulus occur gradually over time. Most patients experience mild cramping that worsens over time until the pain becomes unbearable. Signs that indicate the individual has bowel obstruction include:
Abdominal tenderness.
Severe abdominal pain.
Bilious vomiting (green or yellow vomit).
Abdominal distension or swelling.
Constipation or inability to pass gas.
Blood in the stool.
Rapid heart rate.
Patients often develop hemodynamic instability from septic shock or inadequate fluid intake. If you or your child experiences any of the symptoms, you need immediate evaluation and treatment. Immediate surgery can prevent long-term complications.
Diagnosing Volvulus
Doctors evaluate the symptoms and conduct tests to diagnose volvulus. Symptoms such as abdominal pain, nausea, constipation, and abdominal distension can indicate an individual has volvulus.
Tests include a physical exam and lab tests to check electrolytes. A urine test can help rule out a bladder or urinary tract infection (UTI). Tests may include a CT scan, abdominal X-rays, and contrast enema.
Treatment for Volvulus
Volvulus treatment aims to fix the twisted intestine and prevent further symptoms. Surgeons use an instrument to "untwist" the intestines, which helps restore blood supply and check tissue damage.
The surgeon will place it back in the undamaged intestine in the abdomen. Some patients may require surgery, which usually involves the removal of part of the intestine. A colostomy may be necessary, depending on the extent of the damage.
If tissue necrosis is not extensive, surgeons can reconnect the bowel without performing a colostomy. If not diagnosed and treated early, volvulus can lead to severe and life-threatening complications. Early treatment can improve the outcome.
For more on the warning signs of volvulus, visit the Laparoscopic Surgical Center of New York at our office in New York, New York. Call (212) 879-6677 to book an appointment today.
