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Volvulus - childhood

Contents of this page:

Illustrations

Volvulus
Volvulus
Volvulus - X-ray
Volvulus - X-ray

Alternative Names    Return to top

Childhood volvulus

Definition    Return to top

A volvulus is a twisting of the intestine that can occur in childhood. It causes a blockage, and may cut off blood flow and damage part of the intestine.

Causes    Return to top

A birth defect called intestinal malrotation can make infants more likely to develop a volvulus. However, a volvulus can occur without malrotation.

Volvulus due to malrotation often occurs early in life, usually in the first year.

Symptoms    Return to top

Symptoms are usually severe enough that infants are taken early to the emergency room, which can be critical for survival.

Exams and Tests    Return to top

Treatment    Return to top

Emergency surgery is needed to repair the volvulus. A surgical cut is made in the abdomen. The bowels are untwisted and the blood supply restored.

If a small segment of bowel is dead from a lack of blood flow (necrotic), it is removed. The ends of the bowel are sewn back together. Or, they are used to form a connection of the intestines to the outside, through which bowel contents can be removed (colostomy or ileostomy).

Outlook (Prognosis)    Return to top

Diagnosing and treating volvulus quickly generally leads to a good outcome.

If the bowel is dead (necrotic), the outlook is poor. The situation may be life-threatening, depending on how much of the bowel is dead.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

This is an emergency condition. The symptoms of childhood volvulus develop quickly and the child becomes severely ill. Get medical attention immediately.

References    Return to top

Peterson MA. Large Intestine. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006:chap 94.

Update Date: 8/1/2008

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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