Volvulus (Twisted Intestine)
A friend of mine was rushed to hospital last month with a twisted intestine. I had never heard of this before and until I realised the symptoms and problems, I didn’t realise what a really serious situation it can be.
He had suffered from some internal gas for some time which he put down to general indigestion. He had also suffered from general constipation but there was nothing serious. But then, suddenly and out of the blue, he felt terrible, he was very sick and in dreadful pain. He was given a scan and the diagnosis was quick - volvulus, or twisted intestine.
What this meant was that, somewhere in the long intestines that wind their way around inside our bodies, there was a restriction that was stopping the normal flow of contents through down through the body to the bowel.
We have both small and large intestines. Food first enters the small intestines where the breaking down of the matter continues. The large intestines are the final part of the digestive tract where food waste is converted into faeces. They are an amazing 1.5 metres long, all curled up inside our bodies, and a twist can occur anywhere.
There are five different types of volvulus depending on where the actual twisting has taken place. These include sigmoid colon which affects the part of the large intestine that is closest to the rectum and anus; gastric volvulus when the colon can shift upwards under the diaphragm taking the stomach with it; caecal volvulus which is caused by a bowel obstruction and small intestine volvulus which occurs of course in the small intestine.
Whatever the type, any abnormal twisting of the intestine is going to cause major problems and it is easy to realise the seriousness of a condition that stops food passing through the body normally. If left untreated, volvulus can cause necrosis and rupturing within the gastrointestinal tract and clearly this can turn into a life threatening emergency.
The symptoms can be violent but can also indicate other problems, so the condition has to be quickly but properly identified. This is usually done through physical examination: blood tests, stool samples and of course xrays, ultrasound and radiographic imaging. A scan can usually clearly identify the problem.
Treating volvulus depends on the condition. Sometimes non-surgical treatment can be enough; drugs and possibly the insertion of tubes via the rectum can all be used to untwist an intestine and reduce obstruction.
However, in many cases surgery is required. With modern developments, sometimes keyhole surgery is adequate to untwist the problem area and reset it. Otherwise full surgery can be needed in order to ensure the untwisting, possible rotation and setting everything back as it should be.
The outcome is usually very good indeed and recovery should be straightforward although there can be complications involving electrolyte imbalances, infection and jaundice. If a perforation of the intestine has occurred, then this of course requires additional surgery.
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