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Volvulus - Volvulus symptom, treatment, causes


Volvulus is due to the twisting of a length of intestine into a closed loop, resulting in obstruction of the intestine and often STRANGULATION of the loop, volvulus in babies may be due to congenital abnormalities of the membrane that encloses the intestines, but in adults it usually results from twisting around ADHESIONS (scar tissue joining tissues that are normally separate) within the abdominal cavity.

A volvulus in this case occurring in childhood is a twisting of the bowel with obstruction of the flow of material through the bowel, variable loss of blood supply, and possible tissue death. Gastric volvulus is defined as an abnormal rotation of the stomach of more than 180°, creating a closed loop obstruction that can result in incarceration and strangulation. Compromised blood supply to the involved segment, together with the increase in intraluminal pressure, leads to gangrene and perforation if unrelieved. Volvulus occurs most frequently in middle-aged and elderly men. It results in ischemia (loss of blood flow) and the accumulation of gas and fluid in the portion of the bowel obstructed. The gastric dilatation is one part of the condition and the volvulus or torsion is the second part. It assumes an "upside-down" configuration. In this type, the pylorus and antrum are cranial to the fundus. A volvulus is a problem that can occur after birth as a result of intestinal malrotation. This type is more common in children. The bowel may become obstructed, and/or the blood supply may become decreased.

A volvulus is a loop of the bowel whose nose has twisted on itself. In the stomach, it is called Gastric Volvulus . Volvulus occurs most frequently in the colon, although the stomach and small bowel can also twist. The part of the digestive system above the volvulus continues to function and may swell as it fills with digested food, fluid, and gas. The symptoms and signs may include abdominal pain, nausea, vomiting, and blood in the stool . The treatment is surgery to free the obstruction and ensure normal blood flow to the bowel. Volvulus is a surgical emergency. Volvulus is the Latin word for rolled up or twisted and is derived from the verb volvere, meaning to roll or turn about.

Symptom of Volvulus

Symptoms of Volvulus are the sudden onset of severe abdominal pain followed by vomiting. Volvulus almost always needs emergency surgery to untwist the intestine and correct the cause. Some common Symptoms of Volvulus :

  • Nausea or vomiting.
  • Abdominal tenderness.
  • Shock.
  • Blood in stool.
  • Constipation or difficulty expelling stools.
  • Rapid heart rate.
  • Sudden severe abdominal pain.
  • Abdominal distention.
  • Rapid breathing.
  • Distended abdomen.

Causes of Volvulus

The commmon Causes of Volvulus :

  • The most common cause of gastric volvulus in adults is diaphragmatic defects.
  • Hirschsprung disease.
  • Malrotation of the bowel during fetal development may predispose infants to a volvulus, although a volvulus can occur in the absence of malrotation.
  • Meconium ileus.
  • Chronic constipation ( type of Constipation ).
  • Agenesis of corpus callosum.
  • Situs inversus and asplenia (may be associated with biliary atresia).

Treatment of Volvulus

  • Children may be started on IV (intravenous) fluids to prevent dehydration and antibiotics to prevent infection.
  • Foley catheter placement may be appropriate, especially in older children.
  • The definitive treatment of malrotation and intestinal volvulus is surgical correction.
  • If the twist is incomplete, spontaneous reduction may occur, or may be induced by insertion of a rectal tube via the sigmoidoscope.
  • Electrolytes are replaced aggressively.
  • A tube called a nasogastric (or NG) tube may be guided from the nose, through the throat and esophagus, to the stomach to prevent gas buildup in the stomach.

 

Volvulus - Volvulus symptom, treatment, causes

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