Definition
Volvulus is when part of the large intestine twists on itself and the mesentery. Mesentery is tissue that holds the intestines to the abdomen wall. The twisted intestine cuts off the intestine’s blood supply and affects bowel function.
Volvulus can happen anywhere in the large intestine. It is most common in the lowest part near the rectum.
This condition needs to be treated right away.
Risk Factors
Volvulus is more common in older, inactive people and those who live in care homes. Other things that may raise the risk are:
- Defects in the large intestine
- A history of problems passing stool (poop)
- Previous belly surgery
- Diabetes
- Previous volvulus
- A history of mental health problems
- Hirschsprung disease
- Pregnancy
Symptoms
Symptoms may be:
- Belly swelling
- Belly pain or cramping
- Problems passing stool (poop)
- Nausea and vomiting
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
Blood tests will be done to check for problems.
Imaging will be done to see the intestines and confirm the diagnosis. Tests include:
- Abdominal x-ray
- CT scan
- Lower GI Series with barium enema
- Upper GI Series with barium swallow
Treatment
The goal is to clear the blockage and help the bowels work again. Treatment depends on where the twisting is and if there has been damage.
Care may include:
- IV fluids—to prevent dehydration and shock
- A tube that runs from the nose to the stomach—to prevent gas from building up
- Untwisting the intestine using sigmoidoscopy
- Surgery to remove damaged parts of intestine and connect healthy parts—if needed
RESOURCES
American College of Surgeons https://www.facs.org
American Gastroenterological Association http://www.gastro.org
CANADIAN RESOURCES
Canadian Association of Gastroenterology https://www.cag-acg.org
Canadian Association of General Surgeons http://cags-accg.ca
References
Antatomic problems of the lower GI tract. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/anatomic-problems-lower-gi-tract. Accessed August 9, 2021.
Colonic volvulus. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/colonic-volvulus . Accessed August 9, 2021.
Atamanalp S, Disci E, et al. Sigmoid volvulus: comorbidity with sigmoid gangrene. Pak J Med Sci. 2019 Jan-Feb; 35(1): 288–290.
Revision Information
- Reviewer: EBSCO Medical Review Board Dan Ostrovsky, MD
- Review Date: 07/2021
- Update Date: 08/09/2021