Symptoms of Intestinal Malrotation & Volvulus

Some babies may not have symptoms of intestinal malrotation or intestinal volvulus until they become children, teens or adults. Others may go through their entire life with no symptoms at all. When symptoms are experienced, they include:

• Abdominal swelling or tenderness
• Vomiting of dark green fluid (bilious vomiting)
• Bloodied stool
• Constipation or difficulty in bowel movement
• Shock

Intestinal Malrotation & Volvulus Causes

Intestinal malrotation and volvulus are congenital conditions (present at birth) and result from a problem in the normal formation of the fetal intestines.

Intestinal malrotation occurs when there is a disruption in the fetal development and one of the usual steps that the intestines follow to arrive at the correct position within the abdomen is missed. This condition causes the parts of the intestine to settle in the wrong part of the abdomen, which can cause them to become blocked or to twist.

Intestinal volvulus occurs when the bowel twists on itself as a result of intestinal malrotation and creates serious complications, such as the cutting off of blood supply or intestinal obstruction. If the blood supply is cut off for a prolonged period, some of or the entire intestine may die. This condition is life-threatening and requires immediate surgical attention.

Intestinal malrotation of the bowel during fetal development makes infants predisposed to intestinal volvulus, though intestinal volvulus can occur in the absence of malrotation. Intestinal volvulus due to malrotation usually occurs within the first year of a child’s birth.

Diagnosis of Intestinal Malrotation & Volvulus

In addition to a physical examination and medical history, diagnostic procedures for malrotation and volvulus at the Pediatric Surgical Associates include various imaging studies. These tests are performed to evaluate the position of the intestine, and confirm whether it is twisted or blocked. Tests may include:

• Abdominal X-ray – Special imaging that may show intestinal obstructions, location for the small intestine and other problems.
• Barium Swallow/upper GI test – A procedure performed to examine the intestine for abnormalities. A fluid called barium, a metallic liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed.
• Barium Enema – a procedure performed to examine the intestine for abnormalities.
• Blood test to check dehydration

Intestinal Malrotation & Volvulus Treatment in Orange County

Your Orange County pediatric surgeons at Pediatric Surgical Associates recommend an emergency surgical procedure to repair intestinal volvulus. This procedure will untwist the bowel and restore blood supply. Other procedures may be required to temporarily divert the end of bowels away from the healing tissues, such as colostomy and ileostomy. Both a colostomy and an ileostomy allow bowel contents to empty into a bag. Here is a look at these procedures.

• Resectioning – In this procedure, a small segment of bowel dead from lack of blood flow is resected or removed.
• Colostomy – During this procedure, the cut end of the large intestine is brought to an opening that is made through the abdominal wall.
• Ileostomy – This is performed when the cut end of the small bowel is sewn with a similar opening.

When the child’s organs have healed, the colostomy is removed in a separate procedure to allow the child to pass normal bowel movements.

Your Orange County pediatric surgeons and intestinal malrotation and volvulus specialists at the Pediatric Surgical Associates will be happy to discuss the best treatment option with the best possible outcome for your child. Call 714-361-4480 or Contact Us for more information or to make an appointment.