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| Quick reference medical handouts used
by Pediatric offices |
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Volvulus
A
volvulus is a condition in which the bowel becomes twisted. This twisting causes
obstruction of the intestine, and also often cuts off the blood supply to the
intestine. The resulting death of some or all of the intestine may in turn cause
the person to die.
Malrotation
of the bowel during fetal development may predispose infants to a volvulus,
although a volvulus can occur in the absence of malrotation. Volvulus associated
with malrotation often occurs early in life, frequently in the first year.
Infants develop sudden onset signs of bowel obstruction that may include and or
all of the following. Symptoms are generally dramatic enough that infants are
taken early to the emergency room, which can be critical for survival.
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SYMPTOMS OF
VOLVULUS |
| Abdominal tenderness |
| Nausea or vomiting |
| Vomiting green bile looking
material |
| Bloody or dark red stool |
| Constipation |
| Distended abdomen |
| Shock |
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Volvulus
is diagnosed when the stool tests positive for blood, and x-rays show evidence
of intestinal obstruction.
Emergency
surgery to repair the volvulus is necessary.
An incision is made in the abdomen, the bowels are inspected, and the volvulus
is reduced. This means that the bowels are untwisted and the blood supply
restored.
If
a small segment of bowel is necrotic (dead from lack of blood flow), it is
removed and the ends of the bowels sewn back together, or used to form a
colostomy or ileostomy (tube to the outside through which bowel contents can be
removed -- the term depends on where the tube is formed). If the entire bowel is
necrotic, the outlook is poor, and the situation may be fatal.
Early
recognition of the volvulus and prompt treatment generally results in a good
outcome. If necrosis of the bowel occurs the prognosis is often poor,
depending on how much bowel is necrotic.
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your child’s pediatrician.
Please read our full disclaimer.
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