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Volvulus, Pediatric

Reviewed 10/2018
 


BASICS

DESCRIPTION

Volvulus represents an abnormal rotation (torsion) of the viscera that results in ischemia. Gastric, cecal, and midgut volvulus can occur. Midgut volvulus is the most common form in ...

DIAGNOSIS

HISTORY

  • The primary presenting sign of malrotation in infants is the sudden onset of bilious emesis, especially in the setting of volvulus.

  • In older children, symptoms of malrotation are varia...

TREATMENT

GENERAL MEASURES

  • Any child who presents with bilious emesis and an acute abdomen may require emergent surgical exploration; the concern for midgut volvulus is paramount, and delays for furthe...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Prognosis depends on extent of involvement and degree of bowel ischemia.

  • Most of these children develop a profound ileus and require total parent...

ADDITIONAL READING

  • Aboagye J, Goldstein SD, Salazar JH, et al. Age at presentation of common pediatric surgical conditions: reexamining dogma. J Pediatr Surg.  2014;49(6):995–999. [View Abstract ...

CODES

ICD9

  • 560.2 Volvulus

  • 537.89 Other specified disorders of stomach and duodenum

  • 751.5 Other anomalies of intestine

ICD10

  • K56.2 Volvulus

  • K31.89 Other diseases of stomach and duodenum

  • Q43.8 Other specified ...

FAQ

  • Q: When should workup for volvulus be initiated?

  • A: In any child with bilious emesis

  • Q: What is the best diagnostic study to confirm the diagnosis?

  • A: Limited upper GI to evaluate the duodenal sweep ...

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