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Volvulus - childhood
Alternative namesChildhood volvulus
DefinitionA volvulus, which in this case occurs during 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.
Causes, incidence, and risk factors
A volvulus is a condition in which the bowel becomes twisted. This twisting causes obstruction of the intestine, and also often cuts off the blood supply to the intestine. This can cause death of some or all of the intestine, which is often fatal.
Malrotation of the bowel during fetal development may predispose infants to a volvulus, although a volvulus can occur in the absence of malrotation. Volvulus associated with malrotation often occurs early in life, frequently in the first year.
Signs and tests
Emergency surgery to repair the volvulus is necessary. An incision is made in the abdomen, the bowels are inspected, and the volvulus is reduced. This means that the bowels are untwisted and their blood supply restored.
If a small segment of bowel is necrotic (dead from lack of blood flow), it is removed and the ends of the bowels sewn back together, or used to form a colostomy or ileostomy (tube to the outside through which bowel contents can be removed; the term depends on where the tube is formed). If the entire bowel is necrotic, this can be fatal and the outlook is poor.
Early recognition of the volvulus and prompt treatment generally results in a good outcome. If necrosis of the bowel occurs, depending on how much bowel is necrotic, the prognosis is often poor.
Calling your health care provider
This is an emergency condition! The symptoms of childhood volvulus develop rapidly and the child becomes severely ill.
Update Date: 2/10/2003James P. Dolan, M.D., Department of Surgery, University of California, San Francisco, San Francisco, CA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT