Intestinal Volvulus: What It Is, Causes, and Why It Is Dangerous

In everyday conversation, intestinal volvulus sounds like a verdict and at the same time like a scare story: "the intestine tied itself in a knot." Behind this lies a specific mechanism that doctors see on imaging. Let us explain what it is, what causes it, and why pain of this type is not something to wait out.

Intestinal Volvulus: What It Is

Intestinal obstruction is a partial or complete disruption of the passage of contents through the intestine: food and stool do not move further. It can be mechanical, when something blocks the lumen, or paralytic, when there is no obstruction but the intestine does not work.

Volvulus, or twisting of the intestine, is a variant of mechanical obstruction: a segment of the intestine twists around its own axis. What it is not: it is not "just constipation" and not an illness that can be waited out at home. Complete obstruction is an emergency condition that often requires surgery.

Intestinal Twisting: Which Sections Are Affected

Both the small and large intestine can be affected. Other mechanical variants are nearby: intussusception (one segment of the intestine slides into another, like a telescope), hernia, compression by a tumor. So "obstruction" is not always "volvulus," and vice versa.

What Can Cause Intestinal Volvulus: Causes and Risk Factors

Mechanical causes:

• adhesions and scar tissue after abdominal surgery;
• hernias — external and internal;
• tumors and polyps blocking the lumen;
• intussusception, foreign bodies, fecal impaction, rarely — gallstones;
• inflammatory diseases, such as Crohn's disease.

Anatomical features also predispose: congenital dolichosigmoid, a mobile colon, additional peritoneal pockets and folds, adhesions, elongation of the sigmoid colon in older age, and hernias of the anterior abdominal wall.

Triggering factors are related to diet: a large meal after prolonged fasting (small bowel volvulus is possible), a lot of high-calorie food at once, and in infants under one year — the transition from breastfeeding to formula feeding.

Paralytic obstruction does not involve twisting: it is caused by intestinal infections, electrolyte imbalances such as low potassium, abdominal surgery, reduced blood supply to the intestine, inflammation in the abdominal cavity, kidney and lung diseases, and some medications.

How Intestinal Volvulus Manifests

The picture is usually loud: severe pain or cramping, vomiting, bloating, loud bowel sounds, abdominal enlargement, no passing of gas, constipation. There may be nausea, a feeling of fullness, diarrhea, bad breath — it is not always "textbook."

Diet is indeed linked to risk: we are talking about a large meal after prolonged fasting.

How Doctors Confirm the Diagnosis

During the examination, the doctor looks for bloating, tenderness, and hernia. Next come computed tomography of the abdominal cavity, X-ray, barium enema, and X-ray examination of the upper gastrointestinal tract and small intestine. The diagnosis is made based on the clinical picture and imaging, not on a single symptom from a search engine.

Complications and When Emergency Care Is Needed

Complications: electrolyte imbalances, dehydration, intestinal perforation, infection, jaundice. If blood flow is blocked, infection and tissue death develop — gangrene; the risk is higher with hernia, volvulus, and intussusception. In newborns, paralytic obstruction with destruction of the intestinal wall is a life-threatening condition.

Figures to understand the scale: with unresolved obstruction, fluid losses reach 4 liters per day or more. Mechanical obstruction accounts for 5–15% of cases of severe sudden abdominal pain requiring hospitalization.

See a doctor if stool or gas does not pass, bloating does not resolve, vomiting repeats, or unexplained abdominal pain persists.

Call 103 or 112 if abdominal pain is severe and increasing, the abdomen is bloated, gas and stool do not pass, and vomiting repeats.

And a reminder from me: this text is for reference, it explains the mechanism and signs but does not replace a doctor's consultation — if obstruction is suspected, the decision is made based on examination and imaging, not on an article.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer