Volvulus and Twisted Intestine

Abdomen | Gastroenterology | Volvulus and Twisted Intestine (Disease)


Description

Intestinal volvulus is defined as a complete twisting of a loop of intestine around its mesenteric attachment site. Malrotation may lead to 2 critical complications: mechanical obstruction of the proximal intestine and twisting of the intestines with subsequent ischemia (with or without necrosis) of part or all of the midgut.

Causes and Risk factors

In children is generally related to a congenital defect of the rotation or the mesentery, and in adults it is associated with overuse of laxatives and psychiatric disease (or its treatment). Often, no cause can be identified. Twisting of the bowel causes a blockage of food material and usually decreased blood flow to the affected intestine. The intestine can die causing peritonitis and death.

Diagnosis and Treatment

The initial treatment for a volvulus includes a nasogastric (NG) tube, which is inserted into the nostril, down the throat and esophagus, and into the stomach. The tube is attached to a suction pump, which removes air and digested food. This relieves pressure that has built up behind the obstructed portion of the intestine.

In most cases, surgery is required to correct a volvulus. Surgery may be performed through a laparoscope or through a conventional incision in the abdomen. A laparoscope is a flexible scope that allows a surgeon to view the inside of the abdomen.

Volvulus prognosis depends heavily on correct diagnosis and early surgical intervention to prevent necrosis bowel. ...