Volvulus natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

If left untreated, the majority of patients with volvulus may progress to develop gangrene of the bowel, which can be fatal. Common complications of volvulus include bowel ischemia, gangrene, and necrosis. Prognosis is generally excellent, so long as the affected part of the bowel is resected or untwisted before ischemia occurs, usually within 48-72 hours. If necrosis of the affected bowel has already occurred then the prognosis is poor and may be fatal.

Natural history, complications and prognosis

Natural History

• The symptoms of volvulus include abdominal pain, constipation and inability to defecate or pass gas.
• The symptoms of volvulus typically develop in approximately 3 hours up to several days with an average of 40 days.
• If left untreated, the majority of patients with volvulus may progress to develop ischemia and gangrene of the bowel, which can be fatal. The minority of patients may have spontaneous reduction of the effected portion of the bowel.

Complications

• Common complications of volvulus include:
  • Bowel ischemia
  • Gangrene
  • Perforation
  • Secondary peritonitis
  • Short bowel syndrome

Prognosis

• Prognosis is generally excellent so long as the affected portion of the bowel is decompressed within 48-72 hours.
• If ischemia has led to necrosis of the bowel segment, then the prognosis is poor and may be life threatening.

References

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