Causes and symptoms of volvulus
What is volvulus?
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 the help of 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
Intestinal obstruction can be caused by intestinal spasm or paresis. Increased peristalsis can lead to volvulus, which requires mandatory surgical intervention. The increase in peristalsis, in turn, can be caused by the consumption of foods rich in plant fiber. Intestinal motility also becomes more pronounced with intestinal infection, overdose of certain medications.
A foreign body can enter the intestinal lumen; in some cases, a tumor interferes with the passage of the contents. Sometimes the cause of intestinal volvulus is adhesive disease - a complication after peritonitis. In early childhood, intestinal obstruction can accompany malformations, a violation of the diet.
The causes of volvulus are divided into several types. Mechanical obstruction of the intestine can be caused by a foreign body blocking the lumen of the intestine (obstructive obstruction) and squeezing a separate section of the intestine from the outside (strangulation).
Strangulated intestinal obstruction is accompanied by squeezing of the mesentery and vessels through which blood flows to 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 can develop due to strong motor skills and a long mesentery.
Spasm or paresis of muscle fibers can lead to dynamic and paralytic obstruction, respectively. Such changes in muscle tone may be associated with some diseases of 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, in some diseases of the central nervous system.
In rare cases, in children, spastic volvulus may develop as a result of massive helminthic invasion.
Among the first symptoms of volvulus, cramping pain of varying intensity, nausea and vomiting, which grows over time, appears. After some time, the throwing of feces into the stomach develops and the vomit acquires a characteristic odor. The patient has gas, but 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, swelling rapidly increases.
As part of a medical examination, other symptoms of volvulus become obvious: tachycardia, a drop in blood pressure, an increase in body temperature (with the formation of intestinal necrosis or with peritonitis), dry mouth, during fluoroscopy, bowel loops are visible, swollen with gas or accumulated fluid (Kloyber's bowls).
During palpation, abdominal distension, local seals or abnormal softness of certain areas of the abdomen, pain syndrome are noted, characteristic dripping sounds can be heard auscultation.
Treatment of volvulus
The final diagnosis is carried out within the hospital. In the absence of peritonitis, conservative therapy is performed. The patient is given pain relievers, measures are taken to reduce intoxication, a siphon enema is given, and a gastrointestinal tube is inserted to cleanse the intestines.
It is also important to restore the water-salt balance of the patient, since the acidity of the internal environment of the body is disturbed, which can lead to death.
With the ineffectiveness of drug therapy, an operation is performed: the obstruction is surgically eliminated, measures are taken to resuscitate the damaged section of the intestine, irreversibly damaged sections of the intestine are removed.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".