A twisting of the intestine at least 180 degrees on its mesentery, volvulus results in blood vessel compression and ischemia.
In volvulus, twisting may result from an anomaly of rotation, an ingested foreign body, or an adhesion; in some cases, however, the cause is unknown. Adhesions are common causes of volvulus in pregnant women. Chronic constipation is thought to be a cause in children and the elderly.
Volvulus usually occurs in a bowel segment with a mesentery long enough to twist. The most common area, particularly in adults, is the sigmoid; the small bowel is a common site in children. Other common sites include the stomach and cecum. Volvulus secondary to meconium ileus may occur in patients with cystic fibrosis.
Signs and symptoms
Signs and symptoms of colonic obstruction include nausea, vomiting, cramps, abdominal pain, absence of bowel movements, and failure to pass flatus. Without the appropriate intervention, volvulus can lead to strangulation, ischemia, perforation, peritonitis, and shock.