What is volvulus in an infant - symptoms

Bowel function

Pathological twisting occurs in the small and large intestines with the mesentery or blockage of the space by neoplasms. This is due to anatomical features.

The digestive system consists of several sections of the gastrointestinal tract, salivary glands, liver, pancreas, and gall bladder. It begins with the oral cavity, passes into the pharynx, then the esophagus. Subsequent departments:

• stomach,
• small intestine,
• colon,
• rectum.

The function of the digestive system is to process incoming nutrients into energy and distribute it further in the body. After the gastric stage of digestion, food enters the duodenum of the small intestine. The food lump (chyme) is broken down under the influence of bile.

All necessary enzymes enter the duodenum. Digestion in the large intestine ends with the formation of feces. Beneficial substances from broken down food are absorbed into the blood through the portal vein of the liver.

The organs are attached to the posterior wall of the abdominal cavity using the mesentery. It is a separate organ in the form of a thin film covering all the organs of the cavity. The mesentery unites all parts of the intestine, blood vessels, ligaments, and prevents them from twisting together. Twisting of the small and large intestines compresses the mesentery.

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Symptoms

Severe symptoms indicate a malfunction of the mesentery and digestive tract. Twisting of the loop in infants and children older than one year is characterized by general manifestations:

• acute, sharp painful spasms of a cramping nature occur in the peritoneum;
• incessant vomiting;
• pressure decreases;
• abdominal muscles are tense;
• absence of stool and gases, small volumes of stool with blood spots;
• the stomach increases in volume.

In newborn babies, there is prolonged crying, pulling the legs towards the stomach, and the skin turns blue. Sudden painful spasms, increased body temperature, and prolonged hiccups are possible. Self-medication is not allowed; you must call a doctor at home. Delays in providing medical care can lead to serious complications, and the threat to the child’s life increases.

Rare vomiting spasms are considered symptoms of colon obstruction. Profuse vomiting, which does not alleviate the condition, characterizes the twisting of the loops of the small intestine. Intestinal spasm brings sharp pain.

The first signs, which are acute, will help identify the disease.

Volvulus in children: symptoms, causes, first signs, after which you should worry

Twisting of the intestine around the intestinal or mesenteric axis leads to intestinal obstruction. The disease is called volvulus. The intestinal walls are compressed, which leads to disturbances in the intestinal walls.

Lack of supply of nutritional components and blood circulation leads to necrosis and peritonitis of the digestive tract. This condition is life threatening. Volvulus in children is accompanied by severe painful spasms.

Do not delay treatment.

Characteristics of the disease

Volvulus is characterized by twisting of the intestinal area. Obstruction of products is observed, blood flow is disrupted. The position of the intestine in children is not fixed, so the development of the disease occurs quickly. High mobility of the loops in a child under one year old. As the fat layer increases and the ligaments become stronger, the movement of intestinal loops decreases.

Twisting is dangerous due to necrosis. It happens when the filling, when its integrity is broken, enters the peritoneum. The child may experience inflammatory processes that are life-threatening.

Types of volvulus

Depends on location, manifestations:

• torsion, complete or partial;
• high, low intestinal volvulus;
• twisting of sections of the large or small intestine, sigmoid and cecum.

The form of the disease can be acquired (occurred after birth) and congenital (fetal development defect). It manifests itself as primary (unexplained causes of development) and secondary (arising due to pathologies of the pelvic organs) manifestations. One or more intestinal sections may become twisted.

The large intestine in infants is subject to frequent contractions and fluctuations. The cause of volvulus is peristaltic waves that return.

Manifestations of intestinal obstruction differ from enzyme deficiency. Intestinal pathology is characterized by inhibition of food along the digestive tract (obstruction is created), and enzymatic pathology is characterized by intolerance to certain foods.

Causes

The following reasons can provoke intestinal blockage:

• prolonged constipation;
• foreign body ingress (swelling may form);
• pinching, abdominal injuries;
• regular overeating;
• hiatal hernia;
• infections, polyps;
• long mesentery;
• helminthiasis, blocking the internal space of the intestine;
• development of adhesions, tumor formations;
• paresis or intestinal spasms.

Torsion of loops in newborns occurs due to pathologies of intrauterine development. The organ defect is manifested by torsion. In infants, torsion occurs due to overfeeding with breast milk. Transferring a child under one year of age to formula milk can also provoke bloat. Early introduction of complementary foods also results in intestinal torsion.

Volvulus can lead to inflammatory processes in the abdominal cavity. Infants are more susceptible to the disease than older children. The consumption of fermented milk products and solid foods is limited. Children over three years of age are susceptible to bloat due to poor diet.

Symptoms

Severe symptoms indicate a malfunction of the mesentery and digestive tract. Twisting of the loop in infants and children older than one year is characterized by general manifestations:

• acute, sharp painful spasms of a cramping nature occur in the peritoneum;
• incessant vomiting;
• pressure decreases;
• abdominal muscles are tense;
• absence of stool and gases, small volumes of stool with blood spots;
• the stomach increases in volume.

In newborn babies, there is prolonged crying, pulling the legs towards the stomach, and the skin turns blue. Sudden painful spasms, increased body temperature, and prolonged hiccups are possible. Self-medication is not allowed; you must call a doctor at home. Delays in providing medical care can lead to serious complications, and the threat to the child’s life increases.

Rare vomiting spasms are considered symptoms of colon obstruction. Profuse vomiting, which does not alleviate the condition, characterizes the twisting of the loops of the small intestine. Intestinal spasm brings sharp pain.

The first signs, which are acute, will help identify the disease.

Complications

An advanced form of obstruction is characterized by the entry of feces into the stomach, and the vomit acquires an unpleasant odor. There are symptoms of intoxication of the body with toxins and wastes. If the child's parents do not begin to worry at this moment, dangerous complications arise;

• peritonitis;
• blood poisoning;
• dehydration;
• rupture of the problem area;
• tissue necrosis;
• violation of water-salt level.

This could lead to the death of the child. Treatment of an advanced form leads to problems with the digestive tract; food is poorly digested, which results in constipation or diarrhea. Sometimes the symptoms disappear, the patient does not feel pain, and calms down. A dangerous indicator – against this background, peritonitis develops.

Diagnosis and treatment

The doctor's examination of the baby begins with palpation. There are areas of a soft abdomen, some areas are hard, which creates asymmetry. Treatment is prescribed after determining the cause. Surgery is considered the main stage of therapy.

Additionally, the doctor conducts laboratory tests:

• general examination of blood and urine;
• biochemical blood test;
• general X-ray of the sternum and abdomen, radiography using a contrast agent;
• ultrasonography;
• sigmoidoscopy;
• laparoscopy.

Medication therapy cannot cure bloat; drugs are prescribed during the rehabilitation period. A cleansing enema is considered a conservative method of treatment. It will not help if the volvulus has affected the small intestine. If pathological changes do not disappear, the problem is solved surgically.

The operation consists of untwisting the area of ​​torsion and cutting adhesions. Torsion of the sigmoid region is manifested by repeated volvulus, which manifests itself in an acute or subacute course. Surgical intervention in the sigmoid colon is performed to eliminate the obstruction, preventing recurrence.

During the operation, the elongated mesentery is shortened, unraveled, and part of the intestine is excised.

In children, the treatment uses the method of simultaneous resection. After the intervention, antibiotic treatment is performed, tampons are inserted, and drainage is placed. The resection gives a prognosis for the recovery of children of almost 100%.

Basic treatment procedures

Intestinal torsion in children is treated in the following ways:

• blowing out the inverted area - prescribed at the mild stage;
• laparotomy intervention – allowed with early diagnosis;
• the tumors and adhesions present are excised, parts of the intestine are sewn together;
• IVs are prescribed to cleanse the child’s body of toxic components;
• an incision in the peritoneum to straighten the loops by hand.

A child's body recovers faster than an adult.

Diet food

To avoid re-twisting of the loops, you need to follow a diet. A nursing mother should avoid eating foods that have a negative effect on the digestive tract of the infant. When bottle-fed, overfeeding is not allowed.

The rehabilitation period passes with the inclusion of liquid soups, pureed food, and viscous porridges in the diet. Solid products are completely excluded. Doctor-approved meals are gradually introduced. Meals are split, the diet lasts three months.

Characteristic symptoms

Symptoms of volvulus in newborns may resemble intestinal colic, characteristic of a child of this age. The baby cries, is capricious, suffers from sleep disturbances and bouts of vomiting, and presses his legs under him during a spasm.

If the pathology manifests itself in an older child, then the symptoms of the disease are complemented by other signs. Volvulus can be determined by palpation . Wave-like bowel movements may be visually visible during a spasm.

Symptoms of volvulus may include the following conditions:

• sudden and short-term pain attacks in the intestines;
• bloating, stool retention and the passage of large amounts of gas;
• attacks of vomiting with intestinal contents;
• wave-like bowel movements during an attack;
• formation of lumps in the lower abdomen;
• blood spots in stool;
• vomiting feces mixed with blood;
• complete cessation of stool passage;
• abdominal asymmetry;
• sudden attacks of increased body temperature;
• abdominal muscle tension.

Symptoms of volvulus in children

Intestinal volvulus in a child can appear completely unexpectedly; a seemingly healthy person can suddenly begin to writhe from severe abdominal pain. Attacks can begin and end suddenly, but parents should be alert to a lump in the abdominal area. At the same time, the temperature rises, dry mouth appears, the child loses appetite and often cries, tucking his legs under him.

Often volvulus is accompanied by vomiting, and the vomit has an unpleasant characteristic odor. This is because the contents of the stomach begin to flow back into the esophagus. Your baby's stool may contain blood and mucus.

Another warning sign of this disease may be increased gas formation and stool retention. At the same time, the abdomen may become enlarged and even bloated. This condition is very dangerous for the child, as it can lead to dehydration, necrosis of part of the intestine, or poisoning from decaying intestinal contents.

In a broad sense, volvulus is an acute pathological condition accompanied by blockage of the lumen of a certain section of the intestine.

The most dangerous consequences of this condition are peritonitis and gangrene.

Such diseases pose a threat to the life of a small patient. Self-medication for volvulus should not be practiced under any circumstances. We will talk about the symptoms of volvulus in children in this article.

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General concept

Volvulus is a pathological condition in which the child's intestine twists around the longitudinal axis.

The disease is accompanied by a serious disruption of the blood supply.

Twisting of the intestine causes intestinal obstruction. Children under one year of age and infants are at risk. In adolescents, such pathologies occur only in isolated cases.

Reasons for development

Volvulus can be triggered by external factors or anatomical features of the child’s body.

Numerous diseases act as a provoking factor, the consequences of which are scars on the intestinal tissues, renal colic or other conditions that have a negative impact on the functioning and structure of the digestive organs.

In infants, volvulus can develop against the background of birth injuries, excessive activity, errors in complementary feeding, and ignoring signs of inflammatory processes in the gastrointestinal tract.

The following factors can cause volvulus:

• sharp turns of the body;
• intestinal overflow with feces;
• hiatal hernia;
• progression of tumor formations;
• consequences of inflammatory processes;
• tendency to constipation;
• abdominal injuries;
• adhesions in the intestines;
• infringement;
• abnormalities of organs located near the intestines;
• frequent overeating;
• formation of scar tissue in the intestines;
• intestinal infection by helminths.

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Types and forms

According to the level and location of intestinal volvulus, it is divided into high and low intestinal obstruction, with damage to the sigmoid region, colonic and small intestinal forms. The pathology can be congenital or acquired.

According to etiology, the disease is divided into primary or secondary. In the first case, it is difficult to find out the exact cause of volvulus; in the second, the condition is provoked by specific negative factors. Twisting can be single or multiple.

Types of volvulus:

• rotation of the intestine around its own axis;
• volvulus of the intestine with the mesentery around another intestinal loop;
• rotation of the intestine with the mesentery around the mesenteric axis.

The first symptoms of volvulus are always associated with a violation of the digestive system.

In the early stages of the development of the disease, only an experienced specialist can diagnose the pathology.

The intensity of symptoms depends on the degree of intestinal twisting and the individual characteristics of the child’s body. Some signs may indicate pathology in advance.

For example, the pungent smell of vomit indicates the accumulation of feces in the intestines and a violation of its patency.

Symptoms of volvulus may include the following conditions:

• sudden increase in body temperature;
• pain in the abdominal area;
• acrid smell of vomit;
• attacks of nausea and vomiting;
• no gas formation;
• constipation;
• blood impurities in stool;
• decreased blood pressure;
• abdominal consolidation;
• deterioration of the general condition of the body.

Recommendations for the treatment of intestinal dolichosigma in a child can be found on our website.

Volvulus is one of the deadly diseases. Complications of the disease provoke serious disruption of the gastrointestinal tract.

Due to blocking of the intestinal lumen, an accumulation of feces may form.

Advanced intestinal necrosis increases the risk of death. Even emergency care for such pathology is not always effective.

The consequences of intestinal volvulus can be the following conditions:

• necrosis of part of the intestine;
• development of intestinal obstruction;
• dehydration of the body;
• development of chronic diseases of the digestive system;
• rupture of the problematic intestine;
• intoxication of the body;
• peritonitis;
• the formation of tumors at the site of the twisted section of the intestine.

Diagnostics

Diagnosis of volvulus in children is carried out in several stages. First, the specialist examines the little patient and finds out the parents’ complaints.

A doctor can suspect a pathology by the characteristic thickening of the abdominal area and asymmetrical bloating.

To identify the stage of the disease and the degree of volvulus, additional examination procedures are prescribed. Diagnosis of volvulus in children includes the following types of tests and procedures:

• general blood and urine analysis;
• biochemical analysis of blood and urine;
• x-ray of the chest and abdomen (as well as x-ray with barium enema);
• Ultrasound of the abdominal organs;
• sigmoidoscopy;
• laparoscopy of the abdominal organs;
• colonoscopy.

Volvulus is a fairly common form of intestinal obstruction. This phenomenon occurs due to torsion of any part of the intestine around its own axis with impaired blood circulation.

The subsequent condition of a person depends on the degree of torsion - intestinal volvulus can cause peritonitis or intestinal necrosis, and in some cases even death.

Volvulus is a dangerous condition that should be treated immediately at the first manifestations of the pathology.

What it is?

Volvulus is an acute intestinal obstruction that begins to progress due to rotation of the intestine around the mesenteric axis. This can also occur due to twisting of a certain section of the intestine together with the mesentery around the axis (the process is accompanied by severe circulatory disorders).

Most often, this pathology is diagnosed in children under one year of age. This is due to the fact that their peristalsis has not yet fully normalized, so some part of the small intestine may enter the large intestine.

Reasons for development

The cause of intestinal obstruction may be intestinal spasm or paresis. 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 also becomes more pronounced during intestinal infection and overdose of certain medications.

A foreign body may enter the intestinal lumen; in some cases, the passage of the contents is prevented by a tumor. Sometimes the cause of intestinal volvulus is adhesive disease - a complication after suffering peritonitis. In early childhood, intestinal obstruction can be accompanied by developmental defects and nutritional disorders.

The causes of volvulus are divided into several types. Mechanical intestinal obstruction can be caused by a foreign body blocking the intestinal lumen (obstructive obstruction) and compression of a separate area of ​​the intestine from the outside (strangulation).

Strangulation intestinal obstruction is accompanied by compression of the mesentery and the vessels through which blood flows to this part of the intestine, which can cause gangrene.

In pediatrics, cases of intussusception are common, accompanied by the entry of a separate section of the intestine into an adjacent one with the formation of a circular fold.

Spasm or paresis of muscle fibers can lead to dynamic and paralytic obstruction, respectively.

Such changes in muscle tone may be associated with certain diseases of internal organs: urolithiasis, myocardial infarction.

Also, disturbances in 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 in children may develop due to massive helminthic infestation.

Intestinal volvulus in adults can occur in any part of the intestine where there are ties. Depending on the inversion there are:

• Cecal volvulus;
• Volvulus of the sigmoid colon;
• Volvulus of the small intestine;
• Volvulus of the transverse colon.

Volvulus of the sigmoid colon has some features, so the symptoms are somewhat different from volvulus of the small intestine:

1. Vomit. Occurs at the very beginning of the disease, repeats 2-3 times, in the vomit - gastric contents and bile. Vomiting with impurities of feces can occur at a late stage of the disease, with the development of peritonitis.
2. Pain. More often it occurs acutely and is localized mainly in the lower abdomen; it can radiate to the lower parts of the sacrum and spine.
3. Abdominal asymmetry. Bloating is observed more often in the upper abdomen on the right side.
4. No gas or stool. This condition occurs immediately after volvulus, in contrast to volvulus of the small intestine. In the first moments, strong peristalsis may be observed, which gradually subsides.
5. Cardiac dysfunction: arrhythmia, chest pain, tachycardia. Due to increased pressure in the abdominal cavity, additional stress is created on the blood flow path, which affects the functioning of the heart muscle.
6. Difficulty breathing. Due to the disturbance in the release of gases and feces, they accumulate in the colon and greatly stretch it. The enlarged intestine displaces the abdominal organs and puts pressure on the diaphragm, making breathing difficult.

Symptoms of volvulus

The slightest suspicion of developing intestinal obstruction requires mandatory examination by a specialist surgeon.

Important

If the patient experiences the symptoms described below, an ambulance should be called immediately.

Volvulus of the small intestine

Practical observations of abdominal surgeons (dealing with diseases of the abdominal organs) indicate that this form of obstruction has become much less common than before. The process develops in a clockwise direction and is always difficult. It is determined by the length of the involved section and large angles (number) of rotation. Sometimes the entire small intestine gets caught in the volvulus.

Patients complain of:

• discomfort with heaviness in the abdominal area, loss of appetite, diarrhea (in the prodromal period - the initial phase);
• sudden, sharp attacks of pain, which are significantly alleviated or completely go away with conservative methods of care;
• forced position. The patient most often lies on his back or side and is restless. At the same time, the legs are pulled towards the stomach. Sometimes a person takes a knee-elbow position. In these poses the pain is felt less intensely;
• reflex vomiting of ingested food, the frequency and intensity of which increases. If you delay seeing a doctor for a long time, it becomes fecal in nature;
• stool retention, lack of feces;
• severe weakness, headache, palpitations, high body temperature caused by intoxication - poisoning.

Upon examination, the doctor discovers a swollen abdomen and a lack of normal peristalsis. With percussion (tapping the abdominal wall), the specialist determines gastrointestinal effusion. Against this background, auscultatory noise in the abdomen is replaced by “silence.”

Symptoms of cecal volvulus

This type of pathology is quite rare.

It has three subspecies:

• cecal volvulus with ileum around the common mesentery;
• around the longitudinal axis;
• around the transverse axis.

During the period of obstruction formation, patients periodically experience cramping pain, a tendency to constipation, and the intestines are often swollen.

Features of complaints and symptoms:

• pain syndrome is more often and more severely observed in the right half of the abdomen;
• there is a clear asymmetry of the abdominal wall (due to the swelling of the cecum determined by palpation);
• the doctor determines the presence of Val's symptom and splashing noise, Schiemann-Dans symptom (emptiness in the area of ​​the ileocecal angle, due to displacement of the cecum).

note

The photo shows Meckel's diverticulum in the small intestine area

Acquired consequences include the consequences of chronic diseases:

• adhesions between the intestines and internal organs;
• large tumors, cysts that displace intestinal loops;
• cicatricial changes in the colon after inflammation, devoid of nerve endings;
• spinal cord pathology;
• taking medications that enhance peristalsis (saline and osmotic laxatives), psychotropic drugs.

Complications may occur after a colonoscopy procedure. Volvulus occurs in severe cases of acute appendicitis, Hirschsprung's disease, megacolon, disintegrating tumor, and cystic fibrosis of the intestine. Often accompanies senile dementia, mental disorders, and multiple sclerosis.

Volvulus symptoms in infants

When a child has severe abdominal pain, parents sometimes do not understand how to help him, in which cases they can treat him on their own, and in which cases they can urgently call an ambulance. Home treatment methods are not always safe, especially if the child is tiny.

There is such a pathology as intestinal obstruction. There are many reasons for its occurrence. One of them is intestinal torsion. In children, volvulus is facilitated by the anatomical features of the location of the loops of the small intestine.

The disease is extremely dangerous, it is important to notice its symptoms in time.

• Features of the pathology
• Types of volvulus
• Causes of intestinal torsion
• Symptoms of volvulus
• Diagnostics
• Treatment
• After operation
• Reminder to parents

Features of the pathology

Volvulus is a condition in which the intestines become twisted in any part of the intestine. As a result, the blood supply to the tissues stops, and food obstruction occurs (intussusception).

In children, this pathology develops very quickly due to the fact that intestinal fixation is unstable. The location of the loops is related to the degree of its filling and depends on the position of the body, as well as the tone of the abdominal muscles. Intestinal mobility is especially high in children under 1 year of age.

Later, it gradually decreases due to an increase in the volume of adipose tissue and increased elasticity of the ligaments.

Dangerous consequences of torsion can include necrosis of intestinal tissue, its rupture and entry of contents into the abdominal cavity, and the occurrence of chronic inflammatory diseases.

In the future, tumors may form at the site of intestinal twisting. If the child is not provided with urgent medical care, he may die from gangrene or peritonitis.

Severe complications include poisoning and dehydration.

Volvulus can occur in a child if there are congenital abnormalities in the location of the intestines, as well as in the absence of such pathology.

According to statistics, intestinal torsion is more often observed in boys, since they are more physically active and engage in more aggressive sports.

That is, they more often experience situations associated with a sharp impact on the intestinal area and an increase in intra-abdominal pressure.

Types of volvulus

Depending on the nature of the manifestations and the localization of the site of intestinal torsion, the following types of pathology are distinguished:

• partial or complete twisting;
• low or high volvulus;
• volvulus in the small or large intestine.

In 50% of cases, torsion of the sigmoid colon occurs, and sometimes volvulus of the cecum (parts of the large intestine) is observed.

There are congenital and acquired forms of pathology (that is, torsion caused by defects in the intrauterine formation of the intestine or associated with factors that arose after birth). Volvulus can be primary (the causes of the pathology are unclear) and secondary (occurs as a result of diseases of the pelvic organs).

Twisting can be single or multiple.

Causes of intestinal torsion

The cause of volvulus in children may be poor nutrition. In infants, this is untimely introduction of complementary foods, overfeeding.

Note: Many doctors advise nursing mothers to put their baby to the breast without any regimen, “on demand,” in order to avoid milk stagnation. But this is very harmful for the children’s digestive system, as it can lead to serious illnesses, including volvulus.

In older children, a contributing factor is irregular eating, overeating after prolonged fasting, and eating heavy foods. Intestinal torsion can be provoked by an increase in intra-abdominal pressure during bowel movements if the child suffers from constipation. Displacement of intestinal loops occurs with a sharp turn of the body.

The most common causes of volvulus are:

• entry of a foreign body into the intestines;
• narrowing of the intestine in any area;
• defects in the digestive organs (hernias, adhesions or tumors, incompetence of the digestive valves);
• violation of the size and mobility of the mesentery (the film that envelops the intestines and fastens it to the posterior wall of the abdominal cavity);
• abdominal injuries or postoperative changes in the condition of the pelvic organs;
• inflammatory and infectious diseases of the digestive organs;
• the presence of worms.

Infants are at particular risk. The pathology occurs much less frequently in children of other age groups.

Symptoms of volvulus

The pathology develops in an acute form. Due to the twisting of the intestines, the child feels a sharp, cramping pain in the navel and ribs. The pain quickly intensifies, becomes constant, and begins to radiate to the back. The skin turns pale, sticky cold sweat appears, blood pressure decreases and the pulse quickens.

Vomiting occurs. Due to intestinal obstruction, intestinal contents appear in the vomit. Torsion in the area of ​​the large intestine is characterized by periodic vomiting. When the small intestine is twisted, vomiting, which does not bring relief, is very frequent.

Asymmetrical bloating is observed. There is often no stool. With partial intestinal obstruction, stool mixed with blood may be released, as well as gases with a putrefactive odor. You may notice an involuntary contraction of the walls of the small intestine. When palpating the abdomen, the patient complains of pain in the torsion area.

A newborn baby cries and pulls his legs towards his stomach. As a result of tissue necrosis and inflammation, after a few hours the body temperature rises to 38°C.

Diagnostics

To clarify the diagnosis, an x-ray of the abdominal cavity (irrigoscopy) is performed with the introduction of a barium preparation into the colon using an enema. Colonoscopy or sigmoidoscopy (intestinal endoscopy), and ultrasound of the abdominal cavity may be performed.

Source: https://shokomania.ru/zavorot-kishok-u-grudnichka-simptomy/

Complications

An advanced form of obstruction is characterized by the entry of feces into the stomach, and the vomit acquires an unpleasant odor. There are symptoms of intoxication of the body with toxins and wastes. If the child's parents do not begin to worry at this moment, dangerous complications arise;

• peritonitis;
• blood poisoning;
• dehydration;
• rupture of the problem area;
• tissue necrosis;
• violation of water-salt level.

This could lead to the death of the child. Treatment of an advanced form leads to problems with the digestive tract; food is poorly digested, which results in constipation or diarrhea. Sometimes the symptoms disappear, the patient does not feel pain, and calms down. A dangerous indicator – against this background, peritonitis develops.

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Forecast

Intestinal obstruction in a child is considered a dangerous pathology that can lead to death. There are a lot of factors for its formation, both acquired and innate. Therefore, during pregnancy, the expectant mother needs to lead a healthy lifestyle, eat right, and exercise.

Timely detection and a favorable prognosis will occur only with the initial development of the disease. Therefore, it is important in case of various digestive disorders, in case of severe pain, not to hesitate, but to immediately go to the doctor.

The information" on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Expert of the group for the study of inflammatory diseases. Author of more than 300 scientific papers.

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Clinical manifestations

Symptoms of the disease are associated with the resulting intoxication of the body. The mechanism of its appearance is determined by blocking the access of blood to the intestinal sections. During torsion, a significant part of the intestine is compressed, and the blood supply and innervation to this and nearby areas and the mesentery are cut off. Without blood flow, nutrients and oxygen do not enter the tissues, and necrosis develops. When the intestinal lining dies, its permeability increases, which serves as an entry point for toxins and infection, causing fecal peritonitis.

The onset of the disease is characterized by general symptoms of intestinal dysfunction, which develop into symptoms of obstruction:

• Dyspeptic disorders. The first manifestations are nausea and vomiting. Rare vomiting indicates damage to the thick part, profuse vomiting indicates damage to the thin part. Vomit has a strong pungent odor.
• Stopping gas emissions within a few days.
• Stool disorders in the form of constipation due to blockage of a section of the intestine.
• Bloating or hard belly syndrome.
• Pain in the abdominal area. Severe cramping pain appears in the abdomen, the patient takes a forced position in bed.

In infants, at the onset of the disease, severe pain is replaced by periods of relief; the child can fall asleep and eat. As it worsens, weakness and moodiness appear. During the period of intoxication, body temperature rises and vomiting occurs. Before the complete cessation of bowel movements, blood elements are detected in the stool.

Important! Intoxication is life-threatening for children and adults. The condition is dangerous due to the development of dehydration of brain tissue, systems and organs.

Video - Volvulus

Possible consequences

Volvulus is a condition that poses a threat to the life of a child.
In the absence of timely treatment or emergency medical care, there is a risk of death of the patient. The main danger of the disease is peritonitis, during which general blood poisoning occurs.

The most serious condition is total volvulus, accompanied by significant disruption of the circulatory system. The general symptoms of the disease may manifest themselves with minimal symptoms.

The consequences of intestinal volvulus can be the following conditions:

• intoxication of the body;
• intestinal rupture;
• peritonitis;
• gangrene;
• sepsis;
• inflammation of the peritoneum;
• perforation formation;
• dehydration of the body;
• death;
• increase in body temperature to critical levels;
• intestinal obstruction.

Treatment of volvulus

Treatment of the disease is possible only in a hospital. As a result of the diagnosis, the severity is determined and appropriate treatment is prescribed. In the most severe cases, surgical intervention is performed; in less severe cases, drug treatment and a number of necessary medical procedures (insertion of a gastrointestinal tube, enema, etc.) are performed.

Prokinetics are used to restore intestinal motility. Their necessity is determined by disruption or complete cessation of the functioning of the gastrointestinal tract during volvulus. Non-steroidal anti-inflammatory drugs are also prescribed.

Diet and prognosis

After straightening the volvulus for a certain period, the patient is prescribed a mandatory diet. The diet menu includes pureed oatmeal porridge, eggs, buckwheat, possibly with the addition of milk and light mucous soups; for infants - strictly breastfeeding. What you shouldn't eat is raw fruits, vegetables and juices.

• Recommended reading: Hirschsprung's disease in children

Also, flour products should be completely excluded from the diet, they provoke constipation.

In addition, the diet obliges you to adhere to the following simple rules , which are the prevention of a recurrent outbreak of pathology. Need to:

• feed the child in small portions 5–6 times a day;
• ensure that the child does not go hungry or overeat;
• watch your stool and do not use strong laxatives;
• do not forget about physical activity.

Positive treatment of volvulus should serve as a reason for radical changes in lifestyle and diet.

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Risk factors and complications

Provoking factors for the development of volvulus can be excluded or limited. These include:

• a sharp transition from breastfeeding to formula;
• frequent overeating, overfeeding infants;
• hard physical labor;
• scars and adhesions after surgical interventions;
• weak abdominal muscles;
• constant intake of monotonous food that stimulates peristalsis;
• infectious lesions of the gastrointestinal tract;
• tendency to constipation (in old age);
• blockage of the intestinal lumen by a foreign body;
• poisoning with impaired peristalsis.

Intoxication due to volvulus is life-threatening for the patient. The blood is saturated with toxins, which it delivers to organs, including the brain. Metabolism, water-salt balance, innervation of systems and organs are disrupted, dehydration and tissue necrosis appear. The development of peritonitis requires urgent surgical intervention.

Causes of volvulus

The most common cause of this disease is intestinal spasm. In addition, it can be caused by increased peristalsis, which develops as a result of the presence of excessive amounts of plant fiber in the intestines. Actually, this is why, according to statistics, volvulus is more common among vegetarians.

Another reason is the presence of a foreign body in the intestine. This could be, for example, a tumor or various fairly large objects that have entered the stomach and then into the intestines along with food.

Preventive measures

Prevention of volvulus in a child should be carried out not only after birth, but also at the stage of gestation.
Some pathologies of women during pregnancy can provoke congenital abnormalities in the structure and functioning of the baby’s digestive system.

If the diagnosis has been established and the child has undergone treatment, then it is necessary to exclude all factors that could provoke a recurrence of volvulus.

Prevention of volvulus in children includes the following recommendations:

• the child should not overeat or starve;
• if there is a violation of the bowel movement process, it is necessary to use special medications or cleanse with an enema;
• if there are symptoms of intestinal obstruction, self-medication should be excluded;
• the child is fed 5-6 times a day in small portions;
• full physical activity is a good prevention of deviations in the digestive system;
• Complementary feeding should be appropriate for the child's age.

Volvulus is one of the most dangerous pathologies. Errors in treatment, lack of timely therapy and lack of parental attention to the emerging symptoms of the disease can lead to the death of a child. During an attack, you should never select medications on your own or wait for the spasm to go away on its own. An ambulance must be called as soon as possible.

Diagnostics

When making a diagnosis, the doctor relies on:

• patient survey data;
• objective examination with the establishment of specific symptoms;
• radiography, types of computed tomography, MRI of the abdominal organs;
• Ultrasound and laboratory diagnostic data.

Radiographic signs are manifested by the presence of swollen sections of the intestine with peculiar “cups”, pronounced haustra and a characteristic wide level of fluid (sometimes up to 20 cm). There is a delay in the passage of barium.

Specific X-ray signs of barium examination are observed with volvulus of the sigmoid colon.

The examination allows us to identify 3 stages of the process:

• Turn 180°. The contrast penetrates to the rectosigmoid segment of the intestine, forming a “beak”. By its direction you can determine the turning direction. If the beak is to the left, the gut is to the right and vice versa.
• 360°. The “penguin” is clearly visible on the monitor or picture.
• More than 360°. Only a smaller portion of the intestine is contrasted.

Changes in the blood:

• pronounced leukocytosis;
• accelerated ESR;
• decrease in the number of red blood cells;
• decreased hemoglobin values.

Why does volvulus occur in children?

The main causes of intestinal volvulus are:

• injury in the abdominal area;
• infringement;
• prolonged constipation;
• severe helminthiasis, causing blockage of the intestinal lumen;
• adhesions or tumor formation;
• intestinal spasm or paresis.

In infants, intestinal volvulus is most often a consequence of abnormal intrauterine development, which causes a congenital pathology that leads to volvulus. The next factor is often a forced transition to an artificial form of feeding. In addition, infections, polyps and tumors in the intestinal area influence the development of the disease.

Due to bloat, the child may also develop inflammation of the peritoneum. To prevent this condition from occurring, a number of preventive measures should be taken. The child should not be given a lot of solid foods rich in fiber. You shouldn't feed him before bed either. Instead of fermented milk and nut products, it is better to give decoctions of elderberry and strawberries - they calm intestinal motility.

The most common cause of intestinal volvulus, as observed by pediatric surgeons, is congenital developmental anomalies. They are more concerned with the small intestine. Determined in a newborn or under one year of age.

If the intrauterine formation of the fetus is disrupted, anatomical deviations are possible:

• excessively long mesentery (the most common cause of small intestinal volvulus);
• violation of the size of the initial and final sections of the intestine;
• internal hernia;
• formation of a cyst or tumor on the mesentery;
• functional insufficiency of the sphincter system and valves of the gastrointestinal tract;
• connection of intestinal loops by the common mesentery.

The development of anomalies is associated with:

• with a complicated pregnancy;
• forced treatment of the expectant mother with antibacterial drugs;
• malnutrition;
• hereditary disorders.

In infants, the first signs of obstruction may begin with the introduction of complementary foods or a sudden transition to artificial feeding

What matters is the unpreparedness of the underdeveloped digestive system to accept a new food substance. A reaction occurs in the form of impaired peristalsis: instead of alternating contractions of the circular and longitudinal fibers, pronounced spasms and a reverse wave are formed. Volvulus is caused by constipation in infants and stagnation of feces.

In infants, the first signs of obstruction may begin with the introduction of complementary foods or a sudden transition to artificial feeding

Volvulus in children: symptoms, symptoms and causes

Childhood illnesses cause concern and anxiety among parents. A special place among childhood diseases is occupied by pathologies of the intestine - a long tube that is attached to the walls of the abdominal cavity using a thin mesentery. If for some reason part of the intestine rotates around its axis, a phenomenon called “intestinal volvulus” occurs.

What is volvulus?

Volvulus is also called intestinal obstruction, which is manifested by blocking the lumen of the intestine or its partial twisting.

This type of obstruction occurs as a result of a violation of the correct position of the intestinal loops, that is, their twisting, which in turn leads to poor circulation in this area, and gangrene can develop. This pathology can affect both adults and children.

Intussusception, as it is also called, can cause the intestinal contents to become disturbed, causing the intestines to become overcrowded and distended.

The result can be dehydration and intoxication of the body. Volvulus can occur in any part of the intestine - in the small intestine, in the cecum or sigmoid colon.

This phenomenon can only be eliminated surgically, so delayed treatment can even lead to death.

Causes of development in children

In childhood, you can often hear parents remark that you should not run or jump after eating, as this can lead to volvulus. To some extent, this is true, although there are quite a few reasons for the manifestation of this pathology.

Volvulus in children can occur for various reasons, which are divided into mechanical and dynamic. Mechanical intestinal obstruction can be caused by a foreign body, such as feces, that blocks the intestinal lumen.

Dynamic volvulus occurs as a result of compression of the intestine from the outside, which leads to pinching of blood vessels and impaired circulation in the intestine.

Among the causes of intestinal obstruction are the following:

1. Prolonged constipation, which leads to stool stagnation in the intestines.
2. Sudden movements and turns of the body.
3. Injuries to the abdomen and abdominal cavity.
4. Spasm of intestinal muscle fibers, which occurs with urolithiasis.
5. Infringement of certain parts of the intestine.
6. Helminthic infection of the intestinal lumen.

The cause of volvulus in children 1 year of age is often a hernia of the esophagus. In addition, in infants this pathology may be caused by intrauterine developmental defects.

Symptoms of volvulus in children

Intestinal volvulus in a child can appear completely unexpectedly; a seemingly healthy person can suddenly begin to writhe from severe abdominal pain.

Attacks can begin and end suddenly, but parents should be alert to a lump in the abdominal area.

At the same time, the temperature rises, dry mouth appears, the child loses appetite and often cries, tucking his legs under him.

Often volvulus is accompanied by vomiting, and the vomit has an unpleasant characteristic odor. This is because the contents of the stomach begin to flow back into the esophagus. Your baby's stool may contain blood and mucus.

Another warning sign of this disease may be increased gas formation and stool retention. At the same time, the abdomen may become enlarged and even bloated. This condition is very dangerous for the child, as it can lead to dehydration, necrosis of part of the intestine, or poisoning from decaying intestinal contents.

How to treat?

The diagnosis of volvulus is made in a hospital setting under the supervision of a doctor. In this case, the doctor determines which part of the intestine is damaged and prescribes appropriate treatment.

Therapy can be carried out using conservative methods, but only in the absence of signs of peritonitis. The patient is given an enema, prescribed painkillers in the form of novocaine, and a probe is inserted to cleanse the intestines.

It is also important to restore the water-salt balance, since increased intestinal acidity can lead to irreversible consequences.

If these treatment methods fail, surgery is performed. This eliminates intestinal obstruction, and also takes measures to remove irreversibly damaged parts of the intestine and restore the damaged area.

What not to do?

This pathology can under no circumstances be treated at home, since folk remedies or conventional drugs will not help here; the only solution to this problem may be hospitalization of the child and drug treatment, and in extreme cases, surgical intervention.

When a child has intestinal volvulus, one should not ignore the symptoms of the pathology, self-medicate and give medications without the supervision of a specialist, and also interrupt treatment when the child’s condition improves.

What does Dr. Komarovsky advise?

The famous Russian pediatrician Evgeny Komarovsky believes that the main cause of volvulus in children is a feeding disorder. In infants, the cause of this phenomenon may be the introduction of complementary foods too early and a large amount of solid food in the diet. Parents should be careful when choosing products for children and not make mistakes.

If a child has suffered from this disease and has received the necessary medical care, then in the future the child should adhere to proper nutrition, provide him with a proper drinking regime and lead an active lifestyle. In addition, the child must be regularly shown to the doctor to avoid repeated relapses.

How does the mesentery affect the body?

The mesentery is an important component of the abdominal cavity. Inside the mesentery are the digestive organs, and with its help the intestines are attached to the back wall of the abdomen, thanks to which it is held in place when a person assumes an upright position. But the mesentery is absent in the area of ​​the duodenum and is weakly expressed in the large intestine, in contrast to the area in the jejunum and ileum.

How the mesentery functions:

• Thanks to the innervation of the intestine, the frequency of intestinal waves is regulated by nerve fibers.
• Lymphatic and blood vessels of the mesentery nourish its walls.
• It helps fix the intestinal loops.

Often the causes of volvulus are pathological conditions of the mesentery. In a child, it may be excessively long, due to which increased peristalsis leads to volvulus. In this case, surgery to shorten the mesentery, untwist and resection of the intestine is often required.

When volvulus occurs, the intestines can wrap around themselves.

Volvulus in newborns and infants, how not to miss time

Volvulus in newborns and infants is a super serious topic! God forbid you miss the time when surgery can save your life! Pediatrician Yuri Frantsevich Strelkovsky talks about how intestinal volvulus differs from ordinary constipation in an infant. A word from the pediatrician.

Before the age of 12 months, parents have to endure quite a lot of trials with their baby. At first, these are endless intestinal colics, which go away by 3-4 months, depending on your luck. It would seem that the time of calm has come, but it was not so; teeth immediately begin to cut through. Excessive saliva and the baby's crying will not leave you for up to a year.

Of course, not all children are so problematic; some parents may be very lucky and their baby will not experience any anxiety: neither from colic, nor from teething. But such cases are usually exceptions.

All of the above problems will not pose a risk to your child’s health and life. They are absolutely safe and disappear without a trace after 12-18 months. But among these physiological disorders, serious diseases may be hidden that will require surgical treatment.

Intestinal volvulus in the initial stages can easily be disguised as intestinal colic or teething. For parents, the main thing is to quickly recognize or at least suspect the disease, since treatment without surgery is possible in the early stages. Before learning to recognize the symptoms of the disease, it is necessary to understand the causes of volvulus in newborns.

Causes of volvulus

Mom and Dad, who love their baby, try to give him the best, regardless of his small age.

Early introduction of complementary foods, despite the unpreparedness of the child’s digestive system for new food, leads not only to stool disturbances, but also to disruptions in muscle contractions of the intestinal wall or peristalsis.

This is the first and most common reason for the development of volvulus in a child. In addition, a sharp transition from breastfeeding to artificial feeding can also lead to impaired peristalsis and volvulus.

All other reasons relate to anatomical, congenital anomalies, and this is a purely medical matter and parents cannot influence them in any way. Congenital causes of volvulus, which occur in both newborns and infants:

• previous abdominal surgeries;
• mobility of the intestinal mesentery - the ligament that holds the intestine in a certain position.
• common mesentery for two intestines;
• too long mesentery;
• insufficiency of the intestinal valve system;
• disruption of the innervation of a section of the intestine;
• discrepancy between the sizes of the initial section of the intestine and the distal one.

What are the types of volvulus?

The most common type of intestinal volvulus in newborns and infants is intussusception, when one intestine, due to impaired peristalsis, enters and wedges into another. Most often this occurs at the site of penetration of the small intestine into the large intestine, with possible advancement of the ileum into the ascending colon.

Small intestinal volvulus is much less common and occurs at the junction of the small intestine and the ileum. And even less likely is the penetration of the large intestine into the small intestine, but it also sometimes occurs.

Strangulation intestinal obstruction is typical for older children than for newborns, but it can also occur in infants with congenital pathology of the mesentery. With this type, volvulus occurs due to the formation of nodes in the intestines.

If the intestinal mesentery is too long, if peristalsis is disturbed, it can twist along its axis or around the intestine. Strangulated intestinal obstruction is a rather rare pathology, no more than 4%, but the most severe, both for the child and for doctors.

Adhesive intestinal obstruction develops as a result of the formation of postoperative adhesions. It develops extremely rarely in unoperated children, after infectious diseases of the abdominal cavity.

When an infection enters the abdominal cavity, adhesions are formed - small strands between the walls of the intestine, as well as the mesentery.

As a result, they can compress the intestines and lead to volvulus.

How is volvulus diagnosed?

If you notice similar symptoms or a combination of them in a newborn or infant, you need to consult a surgeon as soon as possible or call an ambulance, which will take you straight to the hands of a hospital emergency room doctor.

First of all, the surgeon checks the baby’s belly; if he finds something suspicious, he sends the child for an ultrasound examination or x-ray of the abdominal organs. After instrumental studies, the diagnosis and further treatment become clear.

Another diagnostic sign is a small amount of blood in the stool. Sometimes it appears only after an enema.

How to cope with the disease

Treatment of newborn children and infants is carried out only in surgical departments, but surgical intervention is not necessary. In most cases, treatment remains conservative, depending on the cause of the volvulus and the duration of the disease.

For intussusception, treatment is most often limited to a siphon enema under ultrasound control, which straightens the intussusception.

In cases of strangulation obstruction, it is extremely rare to do without surgery, which is due to oxygen starvation of the intestinal area, which results in the development of necrosis or death of the part of the intestine compressed by the knot.

Surgical treatment in modern clinics is carried out laparoscopically, through small incisions. If the disease is very advanced, then you have to operate openly in order to be able to save the compressed section of the intestine without removing it.

What is the prognosis for a child after a volvulus?

Depending on the cause of the disease, the prognosis can be completely different. But everything depends on proper feeding, where all feedings are consistent in time, in the volume of the prepared mixture and complementary foods, which should be introduced strictly according to age and little by little.

Congenital causes of volvulus, most often, either outgrow or they are eliminated surgically. It is worth noting that in the last century, quite a large number of newborn children and infants under 1 year died from volvulus. And with the development of medicine, mortality from bloat tends to zero.

Source: https://zaporpobedim.ru/detskie-zapori/zavorot-kishok-u-novorozhdennyx-i-mladencev.html

How to treat?

If there is a suspicion of the development of volvulus in a child, it is necessary to conduct a comprehensive examination of the baby as soon as possible and take appropriate treatment measures. During an attack, you should call an ambulance rather than wait for a pediatrician's visit. In most cases, the disease is treated surgically, but the course of therapy and prognosis directly depend on timely diagnosis.

Medications

Conservative treatment for volvulus is prescribed only with timely diagnosis of the disease. If taking medications does not lead to the desired result, then surgical intervention becomes necessary . The list of medications used in the treatment of this pathology includes drugs to eliminate specific symptoms and medications to strengthen the digestive system.

Examples of drugs used to treat volvulus in a child:

• painkillers (Panadol, Paracetamol);
• antiemetics (Regidron, Enterosgel);
• drugs for restoring intestinal microflora (Linex, Bifidok, Bifilife);
• drugs against parasites (in the presence of worms, Levamisole, Pyrantel are prescribed);
• vitamin complexes containing potassium (preparations must be appropriate for the child’s age);
• presacral blockade with novocaine solution (performed only by doctors).

Folk remedies

Alternative medicine recipes should only be used as an additional remedy to help strengthen the child's digestive system . Decoctions, infusions and procedures will help quickly restore the functioning of the intestines and increase its functionality. No folk remedy can cure volvulus. If the diagnosis is made to an infant or newborn child, then self-medication is excluded.

Examples of folk remedies used to treat volvulus in a child:

• dill seeds (a teaspoon of dill seeds should be poured with a glass of boiling water and simmered over low heat for five minutes; the strained broth should be given to the child in small quantities several times a day);
• beet juice (beet juice should be diluted with water at room temperature in a 1:1 ratio, taken in small portions several times a day);
• fennel seeds (pour a teaspoon of fennel seeds into a glass of water, boil the preparation for five minutes, cool the broth, strain and take a tablespoon several times a day, the product helps eliminate pain in a child during cramps);
• chamomile (pour a teaspoon of chamomile into a glass of boiling water, leave for thirty minutes or boil for five minutes, take a tablespoon several times a day);
• buckthorn bark (pour two tablespoons of the preparation into a liter of boiling water, take the strained infusion several times a day, the product has an anti-inflammatory effect).

Diets

After the bowel straightening procedure, the child is prescribed a special diet. Following a proper diet will help not only speed up the body’s recovery process, but also prevent relapse of the disease.

Raw fruits, vegetables and natural juices must be excluded from the menu . Meals should be small and taken 5-6 times a day. Overeating must be avoided. If these rules are not followed, the effectiveness of the therapy will be reduced.

Features of child nutrition:

• The diet must include pureed porridges made from oatmeal, buckwheat and egg;
• soups should be light and not contain difficult-to-digest ingredients;
• if the operation was performed on a newborn child, then the basis of nutrition should be breastfeeding;
• foods that tend to increase gas formation are excluded from the diet;
• any solid food is excluded from the diet for a certain period.

Other recommendations

In most cases, when intestinal volvulus occurs, it becomes necessary to unwind the problem area.

This procedure can only be done through surgery. The need for surgery is determined depending on the stage of development of the pathology and the general clinical picture of the patient’s health. If the diagnosis was carried out in a timely manner, then volvulus can be eliminated using procedures that do not involve surgical intervention.

Other ways to eliminate pathology:

• siphon enemas;
• washing;
• blowing out a collapsed section of intestine.

How to recognize the symptoms of volvulus in children in time?

In a broad sense, volvulus is an acute pathological condition accompanied by blockage of the lumen of a certain section of the intestine .

The most dangerous consequences of this condition are peritonitis and gangrene.

Such diseases pose a threat to the life of a small patient. Self-medication for volvulus should not be practiced under any circumstances. We will talk about the symptoms of volvulus in children in this article.

How to stop diarrhea in a child? Find out the answer right now.

General concept

Volvulus is a pathological condition in which the child's intestine twists around the longitudinal axis .

The disease is accompanied by a serious disruption of the blood supply.

Twisting of the intestine causes intestinal obstruction. Children under one year of age and infants are at risk. In adolescents, such pathologies occur only in isolated cases.

Reasons for development

Volvulus can be triggered by external factors or anatomical features of the child’s body.

as a provoking factor , the consequences of which are scars on the intestinal tissues, renal colic or other conditions that have a negative impact on the functioning and structure of the digestive organs.

In infants, volvulus can develop against the background of birth injuries, excessive activity, errors in complementary feeding, and ignoring signs of inflammatory processes in the gastrointestinal tract.

cause volvulus:

• sharp turns of the body;
• intestinal overflow with feces;
• hiatal hernia;
• progression of tumor formations;
• consequences of inflammatory processes;
• tendency to constipation;
• abdominal injuries;
• adhesions in the intestines;
• infringement;
• abnormalities of organs located near the intestines;
• frequent overeating;
• formation of scar tissue in the intestines;
• intestinal infection by helminths.

Read about the symptoms and signs of appendicitis in a child here.

Types and forms

According to the level and location of localization, intestinal volvulus is divided into high and low intestinal obstruction, with damage to the sigmoid region, colonic and small intestinal forms . The pathology can be congenital or acquired.

According to etiology, the disease is divided into primary or secondary. In the first case, it is difficult to find out the exact cause of volvulus; in the second, the condition is provoked by specific negative factors. Twisting can be single or multiple .

Types of volvulus:

• rotation of the intestine around its own axis;
• volvulus of the intestine with the mesentery around another intestinal loop;
• rotation of the intestine with the mesentery around the mesenteric axis.

Symptoms and clinical picture

The first symptoms of volvulus are always associated with a violation of the digestive system .

In the early stages of the development of the disease, only an experienced specialist can diagnose the pathology.

The intensity of symptoms depends on the degree of intestinal twisting and the individual characteristics of the child’s body. Some signs may indicate pathology in advance .

For example, the pungent smell of vomit indicates the accumulation of feces in the intestines and a violation of its patency.

Symptoms of volvulus may include the following conditions:

• sudden increase in body temperature;
• pain in the abdominal area;
• acrid smell of vomit;
• attacks of nausea and vomiting;
• no gas formation;
• constipation;
• blood impurities in stool;
• decreased blood pressure;
• abdominal consolidation;
• deterioration of the general condition of the body.

Recommendations for the treatment of intestinal dolichosigma in a child can be found on our website.

How dangerous is the disease?

Volvulus is one of the deadly diseases. Complications of the disease provoke serious disruption of the gastrointestinal tract.

Due to blocking of the intestinal lumen, an accumulation of feces .

Advanced intestinal necrosis Even emergency care for such pathology is not always effective.

The consequences of intestinal volvulus can be the following conditions:

• necrosis of part of the intestine;
• development of intestinal obstruction;
• dehydration of the body;
• development of chronic diseases of the digestive system;
• rupture of the problematic intestine;
• intoxication of the body;
• peritonitis;
• the formation of tumors at the site of the twisted section of the intestine.

Treatment methods

Treatment of volvulus in most cases is carried out in a hospital setting . Therapy can be carried out using conservative or radical methods.

If a cleansing procedure using a siphon enema does not eliminate the accumulation of feces in the intestines, then surgery becomes the only method to solve the problem.

Drug treatment is not able to relieve volvulus. The drugs are used only at the rehabilitation stage.

The main methods of treating volvulus in children are the following procedures:

1. Blowing out the sunken intestine (the method is effective only for mild cases of the disease).
2. Laparotomy surgery (the method is used for early diagnosis of pathology).
3. In the presence of tumors that provoked intestinal volvulus, the formations are cut out and the damaged sections of the intestine are connected.
4. Toxic substances are removed from the child’s body using droppers.
5. Adhesions are eliminated using a tumor removal algorithm.
6. Dissection of the peritoneum and manual reduction of the intestines.

Diet

The diet for volvulus is compiled depending on the age of the child. For breastfed children, maternal nutrition plays an important role .

A woman should give up hard-to-digest foods and exclude foods that can have a negative effect on the baby’s digestive system.

If the stage of breastfeeding and complementary feeding is completed, then the child’s menu implies compliance with general recommendations for patients who have undergone surgery on the digestive organs .

Diet principles for a child:

1. For several days after the operation, the baby is allowed to eat only liquid and light soups, pureed cereals and purees.
2. Solid food is not completely excluded from the diet during the diet.
3. Flour and sausage products, pasta, dairy products, canned food, pickles and smoked products are prohibited .
4. Gradually can be introduced .
5. The child should eat food five or six times a day , but in small portions.
6. The duration of the diet is determined by the doctor (on average, the period of special control of the baby’s diet will be three months).
7. The basis of the diet for infants is only mother's milk or infant formula.

Prevention

Preventive measures for volvulus involve excluding factors that can trigger the development of the disease.

Under no circumstances should you ignore constipation in your baby. The process of bowel movement should be carried out regularly and completely.

If a child has bloating in combination with constipation, elevated body temperature and pain, then a visit to the doctor should not be postponed .

Measures to prevent pathology are the following recommendations:

• prevention of constipation in children;
• control of the baby's diet;
• avoiding overeating;
• timely diagnosis of any intestinal disorders;
• complete treatment of diseases of the digestive system;
• complementary feeding should be appropriate to the child’s age;
• exclusion of excessive physical activity of the child;
• The child’s diet should be rich in fiber and vitamins;
• regular examination by specialized specialists.

A child's body recovers faster than an adult. Surgeries to eliminate volvulus are performed under general anesthesia , and most children tolerate the rehabilitation period well.

If a child has been diagnosed with volvulus, under no circumstances should you self-medicate. Drugs and folk remedies will not be able to eliminate this problem.

You can learn how to save your child with volvulus from the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Source: https://pediatrio.ru/z/zavorot-kishok/simptomy-u-detej-5.html

Prevention

Following simple recommendations will significantly reduce the risk of developing an acute illness.

To prevent the disease you need:

• adherence to a balanced diet. You should avoid overeating and eat a balanced diet;
• treat diseases leading to constipation;
• maintain an active motor mode to eliminate congestion in the abdominal cavity;
• undergo periodic examinations and treatment from gastroenterologists for pathologies of the gastrointestinal tract.

Intestinal volvulus is a serious surgical pathology and requires the mandatory participation of a specialist. If help is provided on time, the chances of recovery without consequences for the body are much higher.

Lotin Alexander, doctor, medical columnist

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What does Dr. Komarovsky advise?

Dr. Komarovsky believes that the main reason for the development of volvulus in infants is feeding errors. Introducing complementary foods too early can negatively affect the state of the baby's digestive system . To avoid such problems, young mothers need to pay special attention to the nutrition of their children and avoid serious mistakes.

After treatment, the following recommendations must be followed:

• compliance with diet rules;
• drinking regime;
• ensuring the child's activity;
• regular examination by a specialist.

Classification

In gastroenterology, it is customary to divide volvulus in children into several types:

• intussusception is not only a factor in the formation of such a pathology, but also its variety;
• strangulation - is a rare, but at the same time the most severe form of intestinal obstruction in children. It differs in that it is most typical not for newborns, but for children of an older age group, but in some cases it can be diagnosed in infants. The main cause is considered to be an excessively long mesentery, which can twist both around its axis and around the intestine.
• adhesive – formed as a result of the formation of postoperative adhesions. If the baby has no history of surgery on the abdominal organs, then this type of volvulus develops quite rarely, often after infectious diseases.

According to the location of the pathological change, volvulus is divided into:

• short;
• high;
• colonic;
• small intestinal.

Signs

The majority of the causes of the disease indicate abnormal functioning of the mesentery, intestines, sudden physical stress or adhesive disease. Due to the wide etiology, it is important to know what causes the symptoms of this disease. The symptoms of volvulus in both infants and older children are similar to the signs of other volvulus.

• Sharp cramping pain in the abdominal area.
• Repeated reflex vomiting.
• Muscle tension in the abdomen.
• Bloating (causes and treatment of bloating).

Also, symptoms of volvulus are diagnosed by palpation and percussion. With volvulus of the small intestine, the child may have a bowel movement after an enema, but the emptying itself occurs only in the lower part of the large intestine. With volvulus of other intestines, symptoms such as stool retention and increased gas formation appear. Gradually, the symptoms intensify, adding to them excessively expressed antiperistalsis and vomiting.

The pain is characterized by suddenness. It is worth noting that often the child’s temperature rises seriously and blood appears in the stool. After the intestinal lumen closes, gas formation stops and stool is completely absent. Also, with bloat, the patient often hiccups, and hiccups can continue for 3 days after surgery.

Since long-term intoxication leads to a serious condition of the child or even death, an urgent call to the doctor’s home is mandatory. In addition, there is a risk of total volvulus, when the patient suddenly feels healthy, but peritonitis begins to develop in his body.

Signs of a volvulus

The main sign of volvulus is severe pain in the lower abdomen. Over time, the unpleasant sensations do not weaken, but on the contrary, they intensify.

Some time after the formation of the pathology, feces begin to penetrate into the stomach. This, in turn, provokes nausea and vomiting. Vomiting emissions are characterized by a sharp unpleasant odor, which, in fact, is characteristic of feces.

Since during intestinal volvulus there are obstacles to the movement of feces in certain areas of the intestine, the patient does not have stool. But at the same time, gas separation is almost always observed.

At the initial stage of the disease, severe bloating occurs. As a result, the abdominal cavity takes on an unnatural shape. As the disease progresses, gastrointestinal motility is seriously impaired until it stops completely.

In addition to the above-mentioned symptoms, others may also be observed during volvulus:

• dry mucous membranes in the mouth;
• high blood pressure;
• increased body temperature;
• tachycardia, etc.

Treatment methods

Therapy of the disease has 2 directions: conservative and surgical. The type of treatment depends on the stage of the process, the type of intestinal rotation, and the age of the patient.

Conservative therapy

Conservative treatment is aimed at aligning the location of the intestines and returning normal bowel function. To achieve this, a gentle procedure is carried out in the inpatient department of the hospital. A barium solution is injected through the rectal passage using an enema. It arrives at the site of volvulus, and anatomical swelling of the intestinal section occurs.

At the recovery stage, intoxication and symptomatic therapy is carried out. The patient receives intravenous drip detoxification solutions that cleanse the blood of waste and toxins: Hemodez, Neohemodez, Reamberin, Reosorbilact. To relieve pain, analgesic drugs Dexalgin, Ibuprofen, Ketanov, Nurofen are used for children. The dosage, frequency and duration of administration are determined individually. To restore impaired intestinal motility, the patient follows a special diet. The obstruction is restored by performing a siphon enema.

Surgery

Surgical (invasive) intervention consists of performing an operation to restore the normal location of all parts of the intestine. It is performed under general anesthesia. For mild forms of torsion, the laparoscopy . Surgical instruments are introduced into the abdominal cavity through 3 punctures without a large incision in the peritoneum. With the help of endoscopes, a section of the intestine is straightened out, and blood circulation is artificially restored.

In the later stages of the disease, laparoscopic surgery is not possible due to complications of the patient's condition. Laparotomy is performed under general anesthesia . After a vertical incision of the peritoneum, the doctor independently observes the area of ​​torsion, determines the type and angle of the torsion. Straightening the volvulus is done manually by the surgeon.

During the recovery period, the patient receives detoxification medications, agents to restore intestinal motility, and vitamins.