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:

• Defects in the large intestine
• A history of problems passing stool (poop)
• Previous belly surgery
• Diabetes
• Previous volvulus
• A history of mental health problems
• Hirschsprung disease
• Pregnancy

Symptoms

Symptoms may be:

• Belly swelling
• Belly pain or cramping
• Problems passing stool (poop)
• Nausea and vomiting

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:

• Abdominal x-ray
• CT scan
• Lower GI Series with barium enema
• Upper GI Series with barium swallow

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.