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Definition

Volvulus is when part of the large intestine twists on itself and the mesentery. Mesentery is tissue that holds the intestines to the abdomen wall. The twisted intestine cuts off the intestine’s blood supply and affects bowel function.

Volvulus can happen anywhere in the large intestine. It is most common in the lowest part near the rectum.

This condition needs to be treated right away.

Causes

The cause of volvulus is not known.

Risk Factors

Volvulus is more common in older, inactive people and those who live in care homes. Other things that may raise the risk are:

Symptoms

Symptoms may be:

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Blood tests will be done to check for problems.

Imaging will be done to see the intestines and confirm the diagnosis. Tests include:

Treatment

The goal is to clear the blockage and help the bowels work again. Treatment depends on where the twisting is and if there has been damage.

Care may include:

  • IV fluids—to prevent dehydration and shock
  • A tube that runs from the nose to the stomach—to prevent gas from building up
  • Untwisting the intestine using sigmoidoscopy
  • Surgery to remove damaged parts of intestine and connect healthy parts—if needed

Prevention

There are no current guidelines to prevent volvulus.

RESOURCES:

American College of Surgeons
https://www.facs.org

American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Canadian Association of General Surgeons
http://cags-accg.ca

REFERENCES:

Antatomic problems of the lower GI tract. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/anatomic-problems-lower-gi-tract. Accessed August 9, 2021.

Colonic volvulus. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/colonic-volvulus . Accessed August 9, 2021.

Atamanalp S, Disci E, et al. Sigmoid volvulus: comorbidity with sigmoid gangrene. Pak J Med Sci. 2019 Jan-Feb; 35(1): 288–290.

Last reviewed July 2021 by EBSCO Medical Review Board Dan Ostrovsky, MD  Last Updated: 8/9/2021