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Definition

A volvulus is when a loop of intestine twists around itself and the tissue that supports and connects it to the back wall of the abdomen. This cuts off blood supply and blocks the intestine. It must be treated right away.

Causes

The cause is not known.

Risk Factors

Things that may raise the risk of this problem are:

  • Problems found at birth, such as:
    • Intestinal malrotation
    • A colon that is longer or larger than normal
    • A colon that is not attached to the abdominal wall properly
  • Irregular bowel habits
  • Chronic constipation
  • High-fiber diet
  • Hirschsprung disease
  • Prior volvulus

Symptoms

Some children do not have symptoms. Those who do may have:

  • Belly pain and swelling
  • Bloody stools
  • Green or yellow vomit
  • Fast breathing and heart rate

Diagnosis

The doctor will ask about your child's symptoms and health history. A physical exam will be done. This may be enough to make the diagnosis.

Images may be taken to confirm the diagnosis. This can be done with:

An endoscopy may be done. It uses a tube with a camera to view inside the intestine.

Treatment

The goal of treatment is to unblock the intestine so the bowel will work as it should. Treatment may be:

Non-Surgical Treatment

A tube may be passed into the rectum to untwist the intestine.

Surgery

Surgery may be done to untwist the intestine. Any damaged parts of intestine will be taken out. The ends of healthy intestine will be sewn together.

Prevention

There are no current methods to prevent this problem.

RESOURCES

American Gastroenterological Association  http://www.gastro.org 

Healthy Children—American Academy of Pediatrics  https://healthychildren.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Caring for Kids—Canadian Paediatric Society  http://www.caringforkids.cps.ca 

References

Intestinal malrotation and volvulus. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/i/intestinal-malrotation. Updated July 2019. Accessed December 30, 2019.

Osiro SB, Cunningham D, et al. The twisted colon: a review of sigmoid volvulus. Am Surg. 2012 Mar;78(3):271-279.

Sigmoid volvulus. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/sigmoid-volvulus . Updated September 29, 2014. Accessed December 30, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 05/08/2020