Intestinal volvulus: how not to miss the first symptoms of intestinal obstruction in children. Why do relapses happen?

Article prepared by:

Intestinal volvulus - intestinal obstruction, accompanied by occlusion of the lumen intestinal tract. In certain areas, there is a violation of blood flow. In case of untimely assistance, the risk of death is high. It is important to seek medical help when the first signs of deviation appear. Intestinal volvulus in children progresses rapidly. The twisting of the intestinal loop is from 90 to 180 degrees. If the patient deviates, the blood flow is disturbed and the movement of fecal masses worsens. There is prolonged constipation and symptoms of intoxication of the body. Proper and timely treatment can avoid a number of complications.

In this article you will learn:

About pathology

Intestinal volvulus in children acute form intestinal obstruction (CT). The CT is wrapped, and the fecal matter ceases to move normally. Diagnosis of the condition is difficult.

The disorder is most common among children and adult vegetarians. Among newborns, volvulus is common. Inexperienced parents often confuse the disorder with teething and colic. The true cause of anxiety and crying can only be established by a doctor.

Boys are more likely to experience volvulus. Doctors attribute this to a difference in behavior.

Factors contributing to the development of the disorder

Only a doctor can establish the true causes of intestinal volvulus in children after complex treatment. The main provoking factors are described in the table.

Long-term constipation can cause volvulus in children. In this case, feces accumulate and contribute to the development of deviation. Doctors identify other less common provoking factors:

• injury to the abdomen;

• a sharp turn of the body;
• hernia of the thoracic opening of the diaphragm;
• adhesive process in the intestinal tract;
• anomalies of adjacent internal organs;
• helminthiases.

In the presence of volvulus of the intestines, fecal matter does not leave the body. Feces decompose, and toxic substances enter the bloodstream and poison the child's body.

Symptoms of intestinal volvulus

Symptoms of intestinal volvulus in children are rapidly progressing. At the initial stages of the formation of a deviation, the child may feel satisfactory. Pathological signs appear periodically.

Gradually, the intensity of the symptoms increases. It is especially difficult to recognize the disease in infants. Children usually have the following symptoms:

• severe pain that causes significant discomfort to the baby;
• tearfulness and anxiety;
• nausea with profuse vomiting;
• lack of gas discharge;
• constipation from 2 to 4 days;

• rapid increase in body temperature;
• blue skin due to lack of oxygen;
• loss of appetite or complete refusal to eat;
• being in the fetal position;
• bloating.

When not timely treatment severe discomfort in children in the abdomen can cause pain shock. The child constantly cries and completely refuses to eat. The condition may worsen with seizures. With the appearance of all the described symptoms, it is important to urgently seek help from a doctor.

Specific signs of bloat include:

• tachycardia;
• lowering blood pressure;
• a jump in body temperature up to 38 degrees;
• dryness in the mouth.

On palpation of the abdomen, it is possible to detect compaction and softness of individual areas. When listening, you can hear specific dripping sounds.

Possible Complications

Complications usually form on the third day after the onset of the disorder. In this case, the child's condition worsens, and the possibility of a favorable outcome becomes almost impossible.

Dehydration is the most common consequence of volvulus. Indomitable vomiting leads to fluid deficiency. In children, in this case, the blood thickens. Arterial pressure decreases. With a loss of 15% of water, a fatal outcome occurs.

When volvulus of the intestines in children increases the permeability in the dead areas of the CT. Slags and toxic components enter the bloodstream. In this case, the child's body temperature rises, muscle and headaches, as well as other symptoms of intoxication.

Also, the disease leads to perforation of the wall of the intestinal tract. Poisons, slags and intestinal bacteria enter the abdominal cavity. Formed fecal peritonitis.

Severe pain syndrome leads to pain shock. In this case, the risk of spontaneous death in the baby increases.

Diagnostic Measures

First of all, it is required to take a picture of children with suspected intestinal volvulus abdominal cavity. An ultrasound is also required. In addition, diagnostics include:

• physical examination and palpation of the abdomen;
• laboratory study of fecal matter.

Only based on the results of the research, the doctor can determine the cause of the formation of the deviation and select the appropriate treatment. It is also important to carry out differential diagnosis with various types of neoplasms.

Only a doctor can prescribe the required studies for children with suspected intestinal volvulus. Independently determine the need for instrumental or laboratory diagnostics impossible.

Therapeutic methods

Treatment of intestinal volvulus is possible only in the surgical department. However, there is not always a need for surgery. Home therapy is ineffective and dangerous. With intussusception, the child is shown a siphon enema under ultrasound control.

Without surgery, it is impossible to do with strangulation obstruction. This is due to oxygen starvation of the segment of the intestine. This is a consequence of necrosis or death of part of the CT.

In modern clinics, surgical intervention is carried out by the laparoscopic method. Children make small incisions in the abdomen. With the advanced form of the disease, you will have to resort to an open operation.

Rehabilitation

After treatment, the prognosis is individual. To a large extent, it depends on the correctness of the rehabilitation period. Babies need to be fed at a certain time, which the doctor will indicate immediately after surgery. Complementary foods are also introduced under the strict supervision of a doctor.

After suffering from volvulus, children must follow a strict diet. The diet may include:

• grated porridge;
• light mucous soups.

Food should be fractional. You can't let a child starve. It is forbidden to overfeed the baby. At the time of rehabilitation, it is important to carefully monitor the stool of a small patient. Showing moderate physical activity.

Intestinal volvulus in children is a twisting of the colon and small intestine between themselves or around the mesentery. Such a process entails a violation of the blood supply and the formation of intestinal obstruction. In most cases, this pathology occurs in newborns and infants, in children over the age of five years it is diagnosed quite rarely.

One or more predisposing factors can cause the formation of such a disorder, but the main ones are early feeding, the presence of congenital anomalies in the structure of organs digestive system, as well as not fully formed gastrointestinal tract.

It is possible to determine intestinal obstruction in children by the following main symptoms - severe anxiety, constant crying, worsening general condition, no outgassing and stool as well as frequent regurgitation or profuse vomiting.

The danger of such a disease in children lies in the fact that it entails the development of life-threatening complications for the baby. For this reason, it is very important to carry out complex diagnostics and start treatment as soon as possible.

Etiology

The most common causes of intestinal volvulus in children are considered to be the early introduction of complementary foods, when the baby is not yet four months old, as well as a very sharp transition from feeding breast milk to artificial mixtures. It is the unpreparedness of the baby's digestive system for new food and its assimilation that is the source of the formation of such a disease.

In addition, the predisposing factors for the occurrence of intestinal obstruction in newborns include:

• surgical interventions on the abdominal organs that were previously transferred by the baby;
• increased mobility of the ligament that holds the intestine in a certain position;
• one mesentery for the large and small intestines;
• excessive length of the ligament;
• discrepancy between the sizes of some parts of the intestine, in particular the initial and distal;
• chronic constipation;
• valvular insufficiency;
• disruption of the functioning of nerve endings in a certain area of ​​\u200b\u200bthe intestine;
• invagination is a process in which one section of the large intestine is introduced into the small intestine or vice versa;
• development of a hernia in the colon or small intestine baby
• intrauterine development of the fetus, which does not meet the standards;
• the formation of a malignant, benign or cystic neoplasm on the mesentery;
• severe helminthiasis.

However, in some cases, even specialists cannot find out the causes of intestinal volvulus in infants. This is due to the fact that the functioning of the organs of the digestive system can be disrupted by diseases of nearby internal organs.

Classification

In gastroenterology, it is customary to divide intestinal volvulus in children into several types:

• invagination - is not only a factor in the formation of such a pathology, but also its variety;
• strangulation - is a rare, but at the same time the most severe form of intestinal obstruction in children. It differs in that it is most characteristic not for newborns, but for children of the older age group, but in some cases it can be diagnosed in infants. The main cause of the occurrence is considered to be an excessively long mesentery, which can twist both around its axis and around the intestine.
• adhesive - is formed as a result of the formation of postoperative adhesions. If there are no operations on the abdominal organs in the anamnesis of the baby’s life, then this type of volvulus develops quite rarely, often after infectious diseases.

Local pathological change twist is divided into:

• short;
• high;
• colonic;
• enteric.

Symptoms

An external manifestation of the fact that the baby has a volvulus of the intestines can be any signs of a disruption in the digestive system, as well as a sharp deterioration in the baby's condition.

At the initial stages of the development of intestinal volvulus, the child may feel normal, since unpleasant sensations disturb him for a rather short period of time. But as the disease progresses, the attacks begin to manifest themselves more intensely and longer.

The main symptoms of this pathology in children under one year old are:

• severe pain spasms that cause significant discomfort to the baby, which is expressed in a change in his behavior - he is restless, constantly crying. Soreness can reach such strength that the baby is threatened with the development of pain shock;
• nausea accompanied by profuse vomiting. In this case, vomit may smell unpleasant. By the nature of the vomiting, you can determine the location of the turn of the intestine. Rare bouts of vomiting indicate that the volvulus occurred in the large intestine, and frequent urges indicate obstruction of the small intestine. Against the background of profuse vomiting, severe intoxication of the body can develop, which poses a threat to the life of the baby;
• lack of discharge of gases and feces from two to four days;
• a sharp increase in body temperature;
• cyanosis of the skin - the most rare symptom of intestinal volvulus in children;
• refusal to eat;
• uncharacteristic for the baby body position - the legs are bent to chest. Thus, he tries to alleviate the pain on his own;
• constant crying and restlessness;
• an increase in the size of the abdomen.

Attacks, when the manifestation of such symptoms is most pronounced, can pass as suddenly as they begin.

The manifestation of the above clinical picture- This is an occasion to seek help from specialists as soon as possible. This is because as the volvulus develops, the symptoms become more pronounced and death can occur in a few days.

Diagnostics

Despite the fact that volvulus in children has quite characteristic manifestations, a detailed examination of the patient is carried out.

Diagnostic measures consist of several stages:

• performing a physical examination with mandatory palpation of the abdomen;
• familiarization with the medical history of a small patient - to search possible causes the appearance of such a state;
• interviewing parents about the time of first onset of symptoms;
• laboratory studies of stool masses - to determine the amount of blood in them. Often, in order to perform such a diagnostic measure, the baby needs to do an enema;
• Ultrasound of the abdominal organs;
• radiography.

Only after performing a certain instrumental diagnostic examination the doctor can make the final diagnosis and decide on the tactics of treatment.

Treatment

The elimination of intussusception in newborns and infants is carried out in the surgical department, since it is a much more serious situation than intestinal volvulus in adults. However, not all cases require surgery as a treatment. Often, therapy is performed by conservative methods.

If the cause of the pathology is intussusception, then therapy is carried out using a siphon enema, which is performed under the supervision of a doctor who observes the procedure through an ultrasound machine. This is quite enough to straighten the intestinal loops.

In cases of strangulation obstruction, surgical intervention is indispensable. This is due to the condition oxygen starvation the affected area of ​​​​the intestine, against which tissue necrosis may occur. The operation is performed laparoscopically, through several small incisions in the abdomen.

In neglected conditions resort to laparotomy intervention. Through a large incision on the anterior wall of the abdominal cavity, doctors release the clamped section of the intestine, without removing it.

After effective treatment Parents receive advice on how to feed their child. It is recommended to give children slimy oatmeal with milk, as well as liquid or pureed soups. Most often, doctors advise to continue breastfeeding.

Complications

Ignoring the symptoms of intestinal volvulus in children threatens the development of such complications:

• necrosis of intestinal tissues;
• dehydration;
• severe intoxication.

Any delay in treatment can lead to the death of the baby.

There is no specific prevention for this disorder. Parents should only timely and gradually introduce complementary foods to the baby, and if necessary, contact as soon as possible. medical professionals that will eliminate the cause of the disease.

In most cases, volvulus in children has a favorable prognosis.

Similar content

Dyspepsia in children is a fairly common disease characterized by a violation of the digestive process. Often, such an ailment is diagnosed in children in the first year of life, and the severity of the course directly depends on the amount of food consumed. This is due to the fact that the volume of food consumed does not always correspond to the capabilities of the gastrointestinal tract. There are several varieties of this syndrome in children - simple and toxic. In the first case, the functioning of the digestive tract is disrupted, in the second, a metabolic disorder is observed.

Hepatomegaly in children is a condition in which the liver becomes enlarged. This is not a disease, but a kind of symptom that indicates that pathology is progressing in the child's body. In no case should it be ignored, since the causes of manifestation can be very serious. For example, hepatomegaly usually accompanies viral hepatitis, heart failure, hepatoma, blood cancer and other ailments. With an increase in the size of the child's liver, it is immediately necessary to show a specialist.

Enterocolitis in children pathological condition, which is characterized by the progression of the inflammatory process in the lumen of the small and large intestines. Symptoms of the disease can occur in children from various age categories, including during the neonatal period. Due to inflammation and dystrophy, several basic intestinal functions are disrupted at once - absorption, digestion, motility and excretion. An exacerbation of the disease in a child usually occurs in the summer, when the baby tries to eat unwashed vegetables or fruits. It is worth noting that enterocolitis in infants and in an older child can develop under the influence of many causative factors.

Intestinal volvulus - acute form of intestinal obstruction, which is formed as a result of partial twisting of the small or large intestine along with the mesentery or the overlap of the space by the tumor.

The twisting of the intestinal loop can be from 90 to 180 degrees. As a result, the victim's blood flow is disturbed, the movement of gases and feces through the intestines stops.

In most cases, with proper and timely treatment, it is possible to overcome this disease and avoid negative consequences. But it is extremely important at the first suspicion to contact emergency medical facilities.

The most common causes of bowel obstruction are early introduction of new foods into the baby's diet and a sharp transition from breastfeeding to artificial. The unpreparedness of the baby's digestive system to assimilate new food, in addition to problems with the stool, leads to peristalsis or malfunctions in the muscle contractions of the intestinal wall.

The rest of the reasons are purely anatomical, most often the result of pathology in the dynamics of the development of the baby's gastrointestinal tract.

Congenital signs of volvulus can occur both in a newborn child and in an infant - this can be a single factor or a complex of negative effects on the gastrointestinal tract and intestinal system:

• abnormal intrauterine development of the baby;
• disproportionate size of the distal and initial department intestines;
• internal hernia of the intestine;
• cyst or tumor of the mesentery;
• rather long mesentery;
• insufficiency of the valvular system of the intestine;
• a common mesentery for a pair of intestines.

Why there is a volvulus of the intestines in a child is sometimes difficult to determine even for medical personnel. The causes of pathologies are also in the development of defects in other organs that can compress the intestines. This pathology can occur with constipation due to the accumulation of feces.

Obstructive acquired intestinal obstruction is very common. The causes of its occurrence are severe helminthic lesions of the body. Worms accumulate in the intestines and serve as a blockage.

Symptoms

Signs - all symptoms indicating deviations from the norm of the intestines and the general condition of the child. Main symptoms:

• Pain syndrome in the abdomen. It is of a convulsive nature. Attacks can be so intense and pronounced that in some cases there is a painful shock.
• Vomiting with a strong odor. Infrequent gag reflexes - symptoms of obstruction of the large intestine. Repeated and profuse vomiting, which does not bring relief to the patient, indicates damage to the small intestine.
• stool retention and the absence of gas discharge for several days.

In addition to the above signs, the patient may experience a sharp increase in temperature and the same rapid jump in its decline. The symptoms of intussusception of the intestine are indisputably hard stomach and no gas emission. The newborn may have symptoms such as blueness skin and pulling the legs to the body.

In the initial stage of the development of the disease, between breaks in paroxysmal sensations, the child feels normal. Over time, the baby's condition worsens, lethargy, weakness occur and it is difficult to calm the patient.

Intestinal volvulus in children causes the rapid development of intoxication and dehydration., which can lead to death within a day. Therefore, the symptoms of the disease should be a call for immediate medical attention.

Treatment

Intestinal obstruction in children is more complex and serious illness than in adults. When intestinal obstruction occurs, due to its twisting or adhesion process, immediate action must be taken. Such a disease not only causes discomfort, but also leads to poisoning of the whole organism.

The disease becomes common cause surgical interventions into the body of infants. If the disease is recognized at the initial stages, then it is possible to do without surgery.

Conservative treatment includes blockade with novocaine solution. Toxins are removed from the blood through the use of droppers. After that, a cleansing procedure with a siphon enema is prescribed. In some cases, intravenous drugs and pain therapy in combination with gastric lavage have a favorable result and improve the patient's condition.

When it is not possible to straighten the intestine using conservative methods and tissue necrosis has begun, laparoscopic or surgical intervention is performed.

Diet and prognosis

After straightening the volvulus of the intestines for a certain period, the patient is prescribed a mandatory diet. The diet menu includes pureed porridges from oatmeal, eggs, buckwheat, it is possible with the addition of milk and light mucous soups, for babies - purely breastfeeding. What is not allowed is raw fruits, vegetables and juices.

• Recommended reading:

Also, flour products should be completely excluded from the diet, they provoke constipation.

Besides, diet obliges to adhere to the following simple rules, which are the prevention of a repeated outbreak of pathology. Need:

• feed the baby in small portions 5-6 times a day;
• make sure that the child does not starve and does not overeat;
• observe the stool and do not use strong laxatives;
• do not forget about physical activity.

The positive treatment of volvulus should be the reason for a radical change in lifestyle and nutrition.

In a broad sense, volvulus is an acute pathological condition, accompanied by blockage of the lumen of a certain part of the intestine.

by the most dangerous consequences such conditions are peritonitis and gangrene.

Such diseases pose a threat to the life of a small patient. Self-medication with volvulus of the intestines can not be engaged in no case. We will talk about the symptoms of intestinal volvulus in children in the article.

How to stop diarrhea in a child? find out right now.

General concept

Intestinal volvulus is a pathological condition in which a child has twisting of the intestine around its longitudinal axis.

The disease is accompanied by a serious violation of the blood supply.

Twisting of the intestine becomes the cause of its obstruction. At risk are children under one year old and infants. Teenagers such pathologies occur only in isolated cases.

Reasons for development

Intestinal volvulus can be caused external factors or anatomical features child's body.

As provoking factor there are numerous diseases, the consequences of which are scars on the tissues of the intestine, renal colic or other conditions that have a negative impact on the functioning and structure of the digestive organs.

In infants, torsion of the intestines can develop against the background of birth injuries, excessive activity, mistakes in feeding and ignoring signs inflammatory processes in the gastrointestinal tract.

Causes volvulus of the intestines can be the following factors:

Types and forms

According to the level and place of localization, intestinal volvulus is divided into high and low intestinal obstruction, with damage to the sigmoid region, large intestine and small intestine. Pathology can be congenital or acquired.

According to the etiology, the disease is divided into primary or secondary. In the first case, it is difficult to find out the exact cause of intestinal volvulus, in the second case, the condition is provoked by specific negative factors. Twisting can be single or multiple.

Kinds volvulus:

• rotation of the intestine around its own axis;
• inversion of the intestine with a mesentery around another intestinal loop;
• rotation of the intestine with the mesentery around the mesenteric axis.

Symptoms and clinical picture

The first symptoms of intestinal volvulus are always associated with violation of the digestive system.

On the early stages of the development of the disease, only an experienced specialist can diagnose the pathology.

The intensity of symptoms depends on the degree of twisting of the intestines and individual features child's body. According to some indications, suspect pathology in advance.

For example, the pungent smell of vomit indicates the accumulation of feces in the intestines and a violation of its patency.

Symptoms volvulus can become the following conditions:

• sudden increase in body temperature;
• pain in the abdomen;
• pungent odor of vomit;
• bouts of nausea and vomiting;
• lack of gas formation;
• constipation;
• impurities of blood in feces;
• decline;
• thickening of the abdomen;
• deterioration in the general condition of the body.

Treatment Methods

Treatment of volvulus in most cases is carried out in a hospital setting. Therapy can be carried out in conservative or radical ways.

If a cleansing procedure using a siphon enema does not eliminate the accumulation of feces in the intestines, then surgical intervention becomes the only method of solving the problem.

Drug treatment is not able to get rid of intestinal volvulus. Drugs are used only at the stage of rehabilitation.

The main methods of treatment volvulus in children are the following procedures:

Diet

The diet for volvulus of the intestines is compiled depending on the age of the child. For breastfed babies maternal nutrition plays an important role.

A woman should give up hard-to-digest foods and exclude foods that can have a negative effect on the baby's digestive system.

If the stage of breastfeeding and complementary feeding is completed, then the child's menu implies compliance general recommendations for patients who underwent surgery on the digestive organs.

Diet principles for a child:

Prevention

Preventive measures for intestinal volvulus include elimination of factors that can lead to the development of the disease.

In no case should you ignore constipation in a baby. The process of emptying the intestines should be carried out regularly and fully.

If the child has bloating in combination with constipation, elevated temperature body and painful sensations, then a visit to the doctor should not be postponed.

Prevention measures pathology are the following recommendations:

A child's body recovers faster than an adult's. Operations to eliminate volvulus held under general anesthesia , and most babies tolerate the rehabilitation period well.

If a child has been diagnosed with volvulus, in no case should you self-medicate. Drugs and folk remedies cannot fix this problem.

You can learn about how to save your child with intestinal volvulus from the video:

We kindly ask you not to self-medicate. Sign up to see a doctor!