Volvulus

A volvulus occurs when part of the intestine is twisted or rotates on itself and the mesentery. The mesentery is the supportive tissue that anchors the intestine to the back wall of the abdomen and contains the essential blood vessels, lymphatics, and nerves to supply the intestine. When the intestine twists, it creates a bowel obstruction that cuts off the intestine’s blood supply, therefore affecting bowel function and ultimately resulting in death to the bowel if not treated promptly. 

Large bowel necrosis (death) results in the requirement of massive bowel resection (removal) possibly leaving an individual with short bowel syndrome and the inability to maintain adequate nutrition by mouth.

The cause of the twisting is not known. Symptoms may include severe abdominal pain, nausea and vomiting, constipation, bloody stools, or abdominal distention.

Diagnosis is based on clinical picture, physical exam, abdominal x-ray, CT scan, and/or upper/lower GI barium series.

Treatment is surgical with correction of the volvulus and resection of any necrotic (dead) bowel. If the resection is massive, intestinal transplant may be indicated.