Volvulus - childhood

Alternative Names: Childhood volvulus

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 of Volvulus - childhood

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.

Volvulus - childhood Symptoms

• Bloody or dark red stools
• Constipation or difficulty releasing stools
• Distended abdomen
• Pain or tenderness in the abdomen
• Nausea or vomiting
• Shock
• Vomiting green material

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

Tests and Exams

• Barium enema
• Blood tests to check electrolytes
• CT scan
• Stool guaiac (shows blood in the stool)
• Upper GI

Treatment of Volvulus - childhood

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).

Prognosis (Outlook)

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.

Potential Complications

• Secondary peritonitis
• Short bowel syndrome (after removal of a large part of the small bowel)

When to Contact a Health Professional

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

Peterson MA. Disorders of the large intestine. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 93.

Volvulus	Volvulus - X-ray

Review Date: 7/26/2010
Reviewed 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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