Volvulus & Intussusception

Syaiful Mukhtar

Volvulus
Volvulus refers to the twisting of a
portion of the intestine around itself
or a stalk of mesentery tissue to
cause an obstruction. Volvulus occurs
most frequently in the colon,
although the stomach and small
bowel can also twist

Volvulus
The part of the digestive system above the
volvulus continues to function and may swell
as it fills with digested food, fluid, and gas. A
condition called strangulation develops if the
mesentery of the bowel is twisted so tightly
that blood flow is cut off and the tissue dies.
This condition is called gangrene. Volvulus is a
surgical emergency because gangrene can
develop quickly, cause a hole in the wall of
the bowel (perforation), and become lifethreatenin

Signs & Symtoms

Abdominal pain
Constipation
Blood in stool
Nausea
Vomiting
Bowel obstruction ..

Gastric volvulus

Caecal volvulus

Ileal volvulus

Tranversal colon volvulus

Sigmoid volvulus

Diagnostic
Physical examination
Radiology
Endoscopy

Diagnostic

Treatment
Surgery
Reposition, resection and
anastomosis

Intussusception
Intussusception is when one segment of
intestine "telescopes" inside of another
causing an intestinal obstruction.
Although it can occur anywhere in the
gastrointestinal tract, it usually occurs at
the junction of the small and large
intestine
The obstruction can cause swelling &
inflammation that can lead to tearing of
the intestines

Intussusception
Intussusceptions cause is unknown,
but is usually preceded by a virus
that produces swelling of the lining of
the intestine, which then prolapses
into the downstream intestine. In
some children, it is caused by a
congenital anomaly of the intestine
such as a polyp or diverticulum

Intussusception

symptoms of
intussusception
The characteristic signs and symptoms of
intussusception are episodic, severe, crampy
abdominal pain alternating with periods of
lethargy. Small children may draw their knees
up to their chest. Other possible symptoms of
intussusception include:
Nausea and vomiting
Rectal bleeding (red jelly-like stools) sometimes
mixed with mucus
These symptoms begin abruptly, usually one
week after a non-specific viral illness.

Diagnostic
Intussusception is associated with an
abdominal mass, which may be felt
upon physical examination.
Ultrasonography is able to identify
the mass with 100 percent accuracy
and is now the first radiologic test
prescribed for patients with
suspected intussusception. Two other
radiologic tests--barium enema and
air contrast enema--also are used to

Diagnostic

Treatment

Treatment

Treatment
Once intussusception is diagnosed, the next step is to
attempt hydrostatic reduction (to push the intestine
back) using a barium enema or air contrast enema (same
test used for diagnosis). This is a radiologic procedure not
a surgical procedure and does not require a general
anesthetic.
These procedures (barium enema and air contrast
enema) have a 60 percent to 70 percent success rate,
with an 8 percent to 10 percent rate of intussusception
recurrence. They have a low risk of complications as well.
If hydrostatic reduction is unsuccessful, then surgery is
required. Surgery may also be done if there is significant
infection, or are too ill for the radiologic procedure

Thanks u