Intestinal Volvulus: Diagnosis and Treatment

Clinical findings of intestinal volvulus are determined by the pattern, severity and duration of bowel obstruction and can be summarized as:

Mobile bowel syndrome: chronic intermittent abdominal pain with spontaneous resolution after the passage of air. A physical evaluation can be observed mild abdominal pain on the right or no symptoms. Usually not associated with bowel infarction or necrosis, however, these symptoms may be a warning of 50% of cases of acute obstruction.

Acute Obstruction: Presence of abdominal pain and vomiting that are not resolved spontaneously. May present increased sensitivity in the abdomen, with or without a palpable abdominal mass, accompanied by bowel sounds. If treated in a timely manner there is a low probability of having death of cells in the intestine.

Acute fulminant Volvulus: People feel irritability and severe abdominal pain that is associated with peritonitis. Often have intestinal necrosis (death of cells in the gut) that threatens the patient’s life.

Diagnosis:
Because most patients with intestinal volvulus have features suggestive of intestinal obstruction, abdominal radiography should be the initial imaging study because it has been observed that through this study identifies all patients with intestinal dilatation (98-100% ) but also other studies should be performed as computerized tomography and colonoscopy to confirm the diagnosis.

Treatment:

Patients with intestinal volvulus should undergo surgery to correct intestinal obstruction.