What is volvulus?
Intestinal volvulus is a violation of the patency of any part of the intestine. This disease is most common among adherents of vegetarian food. If you suspect that a person has this pathology, you should immediately seek help from a specialist, since the prognosis without appropriate treatment is unfavorable: the disease in this case can cause the death of the patient.
Causes of volvulus
The cause of intestinal obstruction may be spasm or paresis of the intestine. Increased peristalsis can lead to intestinal volvulus, which requires mandatory surgical intervention. Increased peristalsis, in turn, can be caused by eating foods rich in plant fiber. Intestinal motility becomes more pronounced with an intestinal infection, an overdose of certain medications.
A foreign body can get into the intestinal lumen, in some cases, the tumor prevents the passage of the contents. Sometimes the cause of intestinal volvulus becomes adhesive disease – a complication after suffering peritonitis. In early childhood, intestinal obstruction may be accompanied by malformations, a violation of the diet.
The causes of intestinal volvulus are divided into several types. Mechanical obstruction of the intestine can be caused by a foreign body blocking the intestinal lumen (obstructive obstruction) and squeezing a separate section of the intestine from the outside (strangulation).
Strangulation intestinal obstruction is accompanied by squeezing of the mesentery and blood vessels through which blood enters this part of the intestine, which can cause gangrene. In pediatrics, cases of intestinal intussusception are common, accompanied by the entry of a separate section of the intestine into the adjacent one with the formation of a circular fold. In addition, volvulus in children may develop due to strong motor skills and a long mesentery.
Spasm or paresis of muscle fibers can lead to dynamic and paralytic ileus, respectively. Such changes in muscle tone may be associated with some diseases of the internal organs: urolithiasis, myocardial infarction. Also, violations of the contraction of muscle fibers can occur after surgery in the intestinal area, after taking potent medications, as a result of lead poisoning, and in certain diseases of the central nervous system.
In rare cases, spastic volvulus of the intestines may develop in children due to massive helminthic invasion.
Symptoms of volvulus
Among the first symptoms of intestinal volvulus, cramping pain of varying intensity, nausea and vomiting that increases over time, appears. After some time, the reflux of feces into the stomach develops and the vomit acquires a characteristic odor. The patient passes gases, but there is no stool. Intestinal motility does not disappear at the onset of the disease, and peristalsis can be seen through the abdominal wall. The abdomen acquires an asymmetric shape, bloating rapidly increases.
As part of a medical examination, other symptoms of intestinal volvulus also become apparent: tachycardia, a drop in blood pressure, an increase in body temperature (during the formation of intestinal necrosis or peritonitis), dry mouth, during fluoroscopy, bowel loops swollen with gas or accumulated liquid (Kloiber’s bowls) are noticeable ).
During palpation, bloating, local indurations or abnormal softness of certain parts of the abdomen, pain syndrome are noted, characteristic dripping sounds can be heard on auscultation.
Treatment of volvulus
The final diagnosis is made in the hospital. In the absence of peritonitis, conservative therapy is performed. The patient is given painkillers, measures are taken to reduce intoxication, a siphon enema is placed, a gastrointestinal tube is inserted to cleanse the intestines.
It is also important to restore the water-salt balance of the patient, as the acidity of the internal environment of the body is disturbed, which can cause death.
If drug therapy is ineffective, surgical intervention is performed: obstruction is surgically removed, measures are taken to resuscitate the damaged section of the intestine, irreversibly damaged sections of the intestine are removed.