Intestinal volvulus – surgical

emergency
Dr. Simona-Gabriela Tudorache, Dr. Ionica Stoica, Dr. Oana
Spiridonescu, As. Univ. Dr. Toli Pătrăncuş

SCUC “Grigore Alexandrescu”, Bucureşti

 Introduction
• Volvulus – torsion of a segment of GI

• Intestinal Volvulus – torsion of an intestinal

segment around its mesenterical axis

• Surgical emergency
 Introduction (II)
• Causes of intestinal volvulus

- Newborn and infant:

- Intestinal malrotation (omphalocele, gastroschisis,
diaphragmatic hernia, intestinal atresia)
- Meconium ileus
- Meckel’s Diverticulum
- Intestinal Duplications
- Mesenteric Cyst
 Introduction (III)
- Older children:
- postoperative adhesions
- Meckel’s Diverticulum

Bowel’s Volvulus – malrotation –

Hirschsprung’s disease, motility disorders,
chronic constipation, MAR
 Material and Method
• Retrospective study

• Study’s population: 2010-2015

• 24 pacients – intestinal volvulus

• Charts, Operative protocols, Hippocrate

system
 Results (I)
• Distribution by sex
Sex

M
12 12
F
 Results (II)

Reasons of admision
Reasons of admision No. of Pacients

Abdominal pain 24

Vomiting 23

The absence of bowel 12

movements
 Results (III)
Age at surgery

9
8
8
7
6 6
6
5
4
4
3
2
1
0
Newborn 1 month-1year 1-7 years >11 years
 Results (IV)
History of surgery

yes
no

18
 Results (V)
Causes of volvulus
10 9
9
8
7
6 5 5
5
4
3
2 1 1 1 1 1
1
0
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 Results (VI)
The moment of surgery

20
19
18
16
14
12
10
8
6
4 4
2
1
0
<12h 24h 48h
 Results (VII)
Intestinal resection

10
yes
no
14
 Length of resection

0
10 cm 20 cm 30 cm
 Results (VIII)

Minimally invasive surgery

• 1 pacient –laparoscopy access:

Right paraduodenal internal hernia

Results (IX)
Mortality

yes
no

20
 Discussions
• Minimally invasive surgery can be used,
except for:
- unstable patient
- suspicion of intestinal necrosis
- Convert to open surgery > 60 minutes
 Discussions (II)

• Most of the studies – distribution by sex is

equal, there are some studies that show
that volvulus is more frequent in male
patients
 Conclusions
• The causes of volvulus differ with pacient’s age

• Prompt diagnosis – early treatment – good

results

• Minimally invasive surgery

- selected cases
- experienced surgeon
Thank you!