Treatment & Care
Malrotation of the intestines is usually not evident until a child's intestine becomes twisted or obstructed and symptoms are present; a volvulus is considered a life-threatening problem.
Children may be started on IV fluids to prevent dehydration and antibiotics to prevent infection. A nasogastric tube may be guided from the nose, through the throat and esophagus, to the child's stomach to prevent a gas buildup.
A volvulus is usually surgically repaired as soon as possible. The intestine is untwisted and checked for damage. Ideally, the circulation to the intestine will be restored after it is unwound, and it will turn pink. If the intestine is healthy, it is replaced in the abdomen. Since the appendix is located in a different area than usual, it would be difficult to diagnose appendicitis in the future; therefore, an appendectomy (surgical removal of the appendix) is also usually performed.
- If a child's blood supply to the intestine is in question, the intestine may be untwisted and placed back into the abdomen. Another operation will be done in 24 to 48 hours to check the health of the intestine. If it appears the intestine has been damaged, the injured section may be removed.
If the injured section of intestine is large, a significant amount of intestine may be removed. In this case, the parts of the intestine that remain after the damaged section is removed may not be able to be attached to each other surgically. Doctors may perform an ostomy, during which the two remaining healthy ends of intestine are moved through openings in the abdomen. Stool will pass through the opening (called a stoma) and then into a collection bag. The ostomy will be temporary and, depending on the amount of intestine that needed to be removed, it will be closed after your child has fully recovered.