Volvulus-Adultby Michael Jubinville, MPHEn Español (Spanish Version)DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionDefinitionA volvulus occurs when part of the large intestine is twisted or rotated on itself and the mesentery. Mesentery is supportive tissue that anchors the intestines to the back wall of the abdomen. The twisted intestine creates a bowel obstruction that cuts off the intestine’s blood supply and affects bowel function.Volvulus can occur anywhere in the large intestine, but it is most common in the sigmoid colon, the lowest part near the rectum. A volvulus requires immediate medical attention.CausesIt is not known what causes the twisting to happen. It may result in a bowel obstruction.Risk FactorsVolvulus is more common in older, inactive people, especially those in assisted living facilities. Other factors that may increase your chance of volvulus include:Congenital defectsElongated or enlarged colonSigmoid colon unattached to abdominal wallNarrow mesenteric connection to the colonPrevious volvulusHistory of chronic constipationHistory of mental health disordersHistory of adhesionsHirschsprung diseaseSymptomsSymptoms may include:Sudden, severe abdominal painAbdominal swellingNausea and vomitingConstipationBloody stoolsDehydrationDiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will be done. Imaging tests will be needed to see internal structures. Tests include:Abdominal x-rayAbdominal ultrasoundCT scanLower GI series with barium enemaUpper GI series with barium swallowTreatmentThe treatment goal is to unblock the obstruction and restore bowel function. Parts of the treatment may include:IV fluids may be given to prevent dehydration and shock. You may need a nasogastric tube to help prevent the build-up of gas in the stomach. A nasogastric tube is a tube inserted through the nose, down the esophagus, and into the stomach.A sigmoidoscope is a tube inserted into the colon through the rectum. The tube allows for the passage of a lighted camera and small surgical instruments. Your doctor can untwist the intestine during this procedure. Untwisting the intestine helps restore blood flow and bowel function. Depending on the extent of intestinal damage, further surgery may be necessary.If necessary, the section of intestine that is damaged is removed. The two remaining healthy ends are put together with stitches or staples. PreventionThere are no current guidelines to prevent volvulus. There are several surgical procedures that may help reduce your chance of having another volvulus. Talk with your doctor about what options may be best for you.RESOURCES: American College of Surgeons https://www.facs.org American Gastroenterological Associationhttp://www.gastro.orgCANADIAN RESOURCES: Canadian Association of Gastroenterologyhttps://www.cag-acg.org Canadian Association of General Surgeons http://cags-accg.caReferences: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. Updated July 2013. Accessed October 2, 2017.Lal SK, Morgenstern R, Vinjirayer EP, Matin A. Sigmoid volvulus an update. Gastrointest Endosc Clin N Am. 2006;16(1):175-187.Osiro SB, Cunningham D, Shoja MM, Tubbs RS, Gielecki J, Loukas M. The twisted colon: a review of sigmoid volvulus. Am Surg. 2012;78(3):271-279.Sigmoid volvulus. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115668/Sigmoid-volvulus. Updated September 29, 2014. Accessed October 2, 2017. Last reviewed September 2017 by EBSCO Medical Review Board Daus Mahnke, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © EBSCO Publishing. All rights reserved.Editorial PolicyPrivacy PolicyTerms and ConditionsSupport