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10 April 2023

What Is Midgut Volvulus? Know Its Symptoms, Causes And Treatment

When The Intestines Twist: Understanding Midgut Volvulus And Its Urgent Treatment

Midgut volvulus is a medical condition that occurs when the small intestine twists on itself, leading to a blockage of blood flow and potential risk of tissue damage. This condition is considered a medical emergency and requires immediate treatment. The midgut refers to the middle portion of the intestine, which extends from the duodenum to the proximal two-thirds of the transverse colon. When the midgut twists, it can cause a blockage in the intestine, leading to ischemia and potential tissue damage. In the following article, Dr Rahul Dubbaka, Consultant, Medical Gastroenterologist, Hepatologist and Therapeutic Endoscopist, CARE Hospitals, Banjara Hills, Hyderabad, shares the causes, signs, diagnosis, risk factors and treatment of midgut volvulus.

Causes Of Malrotation

Midgut volvulus is a relatively rare condition in individuals of all ages, but it is most commonly seen in infants and young children.

  • It is often associated with congenital malformations, such as malrotation, where the intestine does not develop properly in the womb. Malrotation can cause the intestine to be improperly attached to the abdominal wall, which increases the likelihood of twisting.
  • Midgut volvulus is a rare but potentially life-threatening condition that occurs when the small intestine twists on itself, leading to a blockage of blood flow and a potential risk of tissue damage. This condition is considered a medical emergency and requires prompt medical attention.

Midgut Volvulus Symptoms

Midgut volvulus is common in infants and young children.

  • Symptoms of midgut volvulus can be severe and may include sudden and intense abdominal pain, nausea and vomiting, bloating, constipation, diarrhea, and a distended abdomen. In some cases, there may be visible signs of a twisted bowel or blood in the stool.
  • It is often associated with underlying structural abnormalities of the intestines, such as malrotation, where the intestines do not develop properly in the womb. In malrotation, the intestine may not be adequately attached to the abdominal wall, allowing it to twist more easily.

Other Risk Factors For Midgut Volvulus Include:

  1. A history of previous abdominal surgery.
  2. Certain medical conditions, such as cystic fibrosis or Hirschsprung’s disease.
  3. A family history of midgut volvulus.

Midgut Volvulus Diagnosis

Your child may be experiencing midgut volvulus; delayed treatment can lead to severe complications, including intestinal perforation, sepsis, and death. The diagnosis of midgut volvulus is typically made through a combination of physical examination, imaging studies, and laboratory tests. For example, abdominal X-rays, ultrasound, and CT scans may be used to visualize the twisted bowel and confirm the diagnosis. Blood tests may also be performed to assess for signs of infection or other abnormalities.

Surgery: Mainstay of midgut volvulus treatment

Surgery aims to untwist the bowel and restore blood flow to the affected area.

  • In some cases, a portion of the intestine may need to be removed if it has become damaged due to the blockage of blood flow. The specific type of surgery performed will depend on the individual patient’s situation and the severity of the condition.
  • After surgery, patients may need to stay in the hospital for several days or weeks to recover. During this time, they will receive close monitoring and may require additional medical interventions, such as intravenous fluids and pain management.
  • Patients will also be closely monitored for signs of complications, such as infection, bleeding, or bowel obstruction. Long-term follow-up care is also essential for patients who have experienced midgut volvulus. This may include regular check-ups with a healthcare provider and additional imaging studies to assess for any recurrent or ongoing problems.

In Summary

Midgut volvulus is a rare but serious medical condition that requires prompt diagnosis and treatment. Your child may be experiencing symptoms of midgut volvulus, and it is essential to seek medical attention immediately to avoid potential complications and ensure the best possible outcome.

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