Intestinal twisting describes a serious medical condition where a section of the intestines wraps around itself. This twisting can create a blockage, preventing the normal passage of food and fluid through the digestive system. It can also restrict blood flow to the affected part of the intestine, leading to tissue damage. This condition requires prompt medical attention due to its potential for severe complications.
What “Intestinal Twisting” Means
Intestinal twisting is a general term for conditions where a part of the intestine becomes abnormally rotated or displaced. One common form is volvulus, which occurs when a loop of intestine twists around itself and its supporting mesentery. This twisting obstructs the bowel and can cut off its blood supply. Another type is intussusception, where one segment of the intestine slides into an adjacent segment, similar to a collapsing telescope. This telescoping action can block the passage of contents and impair blood flow.
Common Causes of Intestinal Twisting
Several factors can contribute to intestinal twisting, ranging from congenital conditions to acquired issues. A notable congenital factor is intestinal malrotation, an abnormal development of the intestines during fetal growth. This malformation means the intestines are not properly positioned or attached within the abdomen, making them more prone to twisting. Malrotation is a primary cause of volvulus in infants and children.
Acquired conditions can also increase the risk. Surgical adhesions, bands of scar tissue forming after previous abdominal surgery, can create constrictions or anchor points that lead to bowel twisting. An enlarged colon or Hirschsprung disease, a condition affecting nerve cells in the large intestine, can also predispose individuals to volvulus. Other contributing factors include chronic constipation, which can elongate parts of the colon, and pregnancy, due to the growing uterus affecting intestinal positioning.
Recognizing the Signs and Symptoms
The signs and symptoms of intestinal twisting often develop suddenly and can be severe. A prominent symptom is acute, intense abdominal pain, which may feel crampy or colicky. This pain can be accompanied by abdominal distension, where the belly appears swollen due to gas and fluid buildup. Nausea and vomiting are also common, with vomit sometimes appearing greenish (bilious) or even fecal if the obstruction is severe.
Individuals may experience an inability to pass gas or stool. In some cases, blood may be present in the stool, which can appear dark red or jelly-like, particularly with intussusception. Rapid heart rate and signs of shock can also occur, especially if the blood supply to the twisted bowel is compromised.
When to Seek Medical Attention
Intestinal twisting is a medical emergency requiring immediate intervention. Any sudden onset of severe abdominal pain combined with persistent vomiting, abdominal swelling, or an inability to pass gas or stool warrants urgent medical evaluation. Delaying care can lead to serious complications, including the death of intestinal tissue (necrosis) or a tear in the bowel wall (perforation).
These complications can result in a widespread, life-threatening infection within the abdominal cavity, known as peritonitis. Seek emergency medical care without delay if you or someone you know experiences symptoms suggestive of intestinal twisting. Prompt action can significantly improve outcomes and prevent irreversible damage.
Diagnosis and Treatment Approaches
Diagnosing intestinal twisting typically begins with a physical examination and a review of medical history. Imaging tests are essential for confirming the diagnosis. Abdominal X-rays can reveal signs of intestinal obstruction, while CT scans provide more detailed images of the abdomen, showing the twisted bowel and any compromised blood supply. An upper gastrointestinal (GI) series or barium enema may also be used to visualize the intestines and detect blockages or abnormal positioning.
Once diagnosed, treatment often involves surgical intervention. For volvulus, surgery may involve untwisting the affected segment and, if necessary, removing any bowel sections that have lost their blood supply. This procedure, known as a bowel resection, involves reattaching the healthy ends. In some cases of sigmoid volvulus, a sigmoidoscopy might be attempted to untwist the colon initially, but surgery is often required to prevent recurrence. For intussusception, especially in children, non-surgical methods like an air or liquid enema may be attempted first to push the telescoped bowel back into place; however, if unsuccessful or if there are signs of tissue damage, surgical correction becomes necessary.