II. Definitions

  1. Volvulus
    1. Twisting of intestinal loop around attachment to mesentery
    2. Can occur at Stomach, Small Intestine, cecum, transverse colon or sigmoid colon
  2. Midgut Volvulus
    1. Associated with Intestinal Malrotation
    2. Presents in infants in 90% of cases

III. Symptoms: Midgut Volvulus (infants and children)

  1. Infants
    1. Bilious Emesis
    2. Sudden onset of Abdominal Pain
  2. Older children
    1. Chronic intermittent Vomiting and abdominal cramping
    2. Failure to Thrive
    3. Constipation
    4. Bloody Diarrhea

IV. Symptoms: Sigmoid Volvulus (elderly)

  1. Abdominal Pain
  2. Abdominal distention
  3. Obstipation (unable to pass stool or flatus)
  4. Vomiting is a late and ominous sign

V. Signs

  1. Abdominal exam may be benign
  2. Heme positive stool
    1. Late sign suggesting infarcted bowel

VI. Differential Diagnosis

  1. See Abdominal Pain Causes

VII. Imaging

  1. Upper gastrointestinal series
    1. Higher Test Sensitivity for Intestinal Malrotation than for Volvulus

VIII. Complications

  1. Intestinal infarction (high mortality)

IX. Management

  1. Emergent surgical management
    1. Delay risks

X. Resources

  1. Hebra (2012) Intestinal Volvulus, Medscape

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Ontology: Intestinal Volvulus (C0042961)

Definition (MSHCZE) Obtočení rotace střeva kolem osy kolmé na jeho průběh vedoucí k zaškrcení vyživujících cév a odumření jeho příslušné části s následným vznikem ileu a zánětu pobřišnice. Vzniká např. kolem srůstu pooperačního. Projevuje se příznaky náhlé příhody břišní - bolest, nevolnost, zvracení, střevní neprůchodnost, peritoneální příznaky, šok. Stav vyžaduje neodkladné operační řešení. (cit. Velký lékařský slovník online, 2012 http://lekarske.slovniky.cz/ )
Definition (NCI) Twisting of a loop of bowel that results in intestinal obstruction.
Definition (MSH) A twisting in the intestine (INTESTINES) that can cause INTESTINAL OBSTRUCTION.
Concepts Disease or Syndrome (T047) , Anatomical Abnormality (T190)
MSH D045822
ICD9 560.2
ICD10 K56.2
SnomedCT 197057008, 155774005, 197061002, 90738007, 9707006
English Volvulus NOS, volvulus, volvulus (diagnosis), Volvulus of intestine, Intestinal Volvulus [Disease/Finding], bowel volvulus, intestinal volvulus, bowel torsion, intestine volvulus, Volvulus (& [torsion of bowel]) (disorder), Volvulus NOS (disorder), Volvulus (& [torsion of bowel]), Volvulus (disorder), Volvulus, Intestinal Volvulus, Volvulus, Intestinal, Volvulus, Intestine, Twisting of intestine on mesenteric axis, Torsion of bowel, Intestinal volvulus (disorder), Intestinal volvulus, Obstruction by kinking, Obstruction by torsion (morphologic abnormality), Obstruction by torsion, Obstruction by twisting, bowel; torsion, torsion; bowel, Intestinal volvulus, NOS, Obstruction by kinking, NOS, Obstruction by torsion, NOS, Obstruction by twisting, NOS, Knotting of intestine, bowel, or colon, Strangulation of intestine, bowel, or colon, Torsion of intestine, bowel, or colon, Twist of intestine, bowel, or colon, Volvulus of bowel
Dutch volvolus, volvolus van de darm, darm; torsie, torsie; darm, Volvulus, Darmvolvulus
German Verschlingung, Volvulus, Darmverschlingung, Volvulus intestini
Portuguese Vólvulo, Vólvulo intestinal, Vólvulo Intestinal, Volvo Intestinal
Spanish Vólvulo, Vólvulo intestinal, vólvulo, SAI (trastorno), vólvulo, SAI, obstrucción por acodadura, obstrucción por torsión (anomalía morfológica), obstrucción por torsión, torsión del intestino en el eje mesentérico, vólvulo intestinal (trastorno), vólvulo intestinal, Vólvulo Intestinal
Italian Volvolo dell'intestino, Volvolo, Volvolo intestinale
Japanese 腸の軸捻転, チョウノジクネンテン, チョウネンテン, 腸捻転症, 腸軸捻, 腸軸捻症, 腸軸捻転, 捻転-腸, 腸管軸捻, 腸軸捻転症, 腸管軸捻症, 腸捻転, 軸捻-腸管
Swedish Volvulus
Czech střeva - zauzlení, volvulus intestini, Volvulus střeva, Volvulus, volvulus, zauzlení střeva, malrotace střeva, malrotace střevní
Finnish Suolenkiertymä
Russian KISHECHNIKA UZLOVAIA NEPROKHODIMOST', КИШЕЧНИКА УЗЛОВАЯ НЕПРОХОДИМОСТЬ
Korean 장축염전증
Polish Skręt jelit
Hungarian Volvulus, Bél volvulusa
Norwegian Volvulus, Intestinal volvulus
French Volvulus, Volvulus de l'intestin, Volvulus intestinal

Ontology: Congenital malrotation of intestine (C0221210)

Definition (NCI) A congenital abnormality in which the intestine is abnormally rotated (twisted). It may result in intestinal obstruction.
Concepts Congenital Abnormality (T019)
MSH C562456
SnomedCT 29980002, 204756000, 48641006
English Incomplete rotation intestine, Volvulus neonatorum, Volvulus of midgut, VOLVULUS OF MIDGUT, Malrotation of the gut, Malrotation of gut, intestinal malrotation, intestinal malrotation (diagnosis), Gut malrotation, Congenital malrotation of intestine, congenital malrotation, intestine malrotation, midgut volvulus, intestines malrotation, volvulus neonatorum, malrotation intestine, Intestinal Malrotation, Volvulus Of Midgut, Malrotation of bowel, Congenital Malrotation of Intestine, Malrotation of intestine, Incomplete rotation of intestine, Congenital malrotation (morphologic abnormality), Congenital malrotation of intestine (disorder), Congenital malrotation, bowel; malrotation, malrotation; bowel, Congenital malrotation, NOS, Intestinal malrotation
Dutch malrotatie van darmen, darm; malrotatie, malrotatie; darm
French Anomalie de la rotation intestinale
Italian Malrotazione intestinale
Portuguese Má rotação intestinal
Spanish Malrotación intestinal, malrotación congénita del intestino (trastorno), malrotación congénita del intestino, rotación anómala congénita de intestino (trastorno), rotación anómala congénita de intestino, rotación patológica de origen congénito (anomalía morfológica), rotación patológica de origen congénito
Japanese 腸回転異常, チョウカイテンイジョウ
Czech Abnormální rotace sttřev
Hungarian Intestinalis malrotatio
German Malrotation

Ontology: Volvulus of the small bowel (C0238199)

Concepts Pathologic Function (T046)
SnomedCT 197058003
Dutch volvulus van dunne darm
French Volvulus de l'intestin grêle
German Volvulus des Duenndarms
Italian Volvolo dell'intestino tenue
Portuguese Vólvulo do intestino delgado
Spanish Vólvulo de intestino delgado, vólvulo del intestino delgado (trastorno), vólvulo del intestino delgado
Japanese 小腸捻転, ショウチョウネンテン
English small intestine volvulus, small intestine volvulus (diagnosis), small bowel volvulus, volvulus of the small bowel, Volvulus of small intestine, Volvulus of the small bowel, Volvulus of the small bowel (disorder), Volvulus of small bowel
Czech Volvulus tenkého střeva
Hungarian Vékonybél volvulusa

Ontology: Volvulus of duodenum (C0267354)

Concepts Disease or Syndrome (T047)
ICD10 K31.5
SnomedCT 79812002
English duodenal volvulus, duodenal volvulus (diagnosis), Volvulus of duodenum, Duodenal volvulus, Volvulus of duodenum (disorder)
Spanish vólvulo de duodeno (trastorno), vólvulo de duodeno

Ontology: Congenital volvulus (C0345252)

Concepts Congenital Abnormality (T019)
SnomedCT 204768009, 253786009
English congenital volvulus, congenital volvulus (diagnosis), Congenital volvulus, Congenital volvulus (disorder), congenital; volvulus, volvulus; congenital
Dutch congenitaal; volvulus, volvulus; congenitaal
Spanish vólvulo congénito (trastorno), vólvulo congénito