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Volvulus - childhood


Definition:

A volvulus is a twisting of the intestine that can occur in childhood. It causes a blockage that may cut off blood flow. Part of the intestine may be damaged as a result.

Alternative Names:

Childhood volvulus

Causes:

A birth defect called intestinal malrotation can make an infant more likely to develop a volvulus. However, a volvulus can occur without this condition present.

Volvulus due to malrotation occurs most often in the first year of life.

Symptoms:

Symptoms are very often so severe that an infant is taken to the emergency room. Early treatment can be critical for survival.

Exams and Tests:
Treatment:

In some cases, colonoscopy can be used to correct the problem. A colonoscopy uses a flexible tube with a light on the end that is passed into the colon (large bowel) through the rectum.

Emergency surgery is often needed to repair the volvulus. A surgical cut is made in the abdomen. The bowels are untwisted and the blood supply is 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 then sewn together. Or, they are used to form a connection of the intestines to the outside of the body (colostomy or ileostomy). Bowel contents can be removed through this opening.

Outlook (Prognosis):

Most of the time, prompt diagnosis and treatment of volvulus 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:
When to Contact a Medical Professional:

This is an emergency condition. The symptoms of childhood volvulus develop quickly and the child will become very ill. Get medical attention right away if this happens.

References:

Peterson MA. Disorders of the large intestine. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 95.


Review Date: 8/11/2014
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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