Volvulus causes

Midgut volvulus occurs in patients (usually in infants) that are predisposed because of congenital intestinal malrotation. Segmental volvulus occurs in patients of any age, usually with a predisposition because of abnormal intestinal contents (e.g. meconium ileus) or adhesions. Volvulus of the cecum, transverse colon, or sigmoid colon occurs, usually in adults, with only minor predisposing factors such as redundant (excess, inadequately supported) intestinal tissue and constipation.

Causes of volvulus can either be congenital or acquired:

• Acquired causes of volvulus include:^[1][2][3]
  • Adhesions
  • Iatrogenic e.g. lower GI endoscopy
  • Bowel atony
  • Pregnancy
  • Crohn’s disease
  • Chagas disease
  • Age more than 50 years old
  • Chronic constipation
  • Dilated colon
  • Colonic dysmotility
  • Laxative dependence
  • Crohn’s disease
  • Chagas disease
  • Phrenic nerve paralysis
• Congenital causes of volvulus include:^[4]
  • Hirschsprung’s disease
  • Paraesophageal hernia
  • Hiatal hernia
  • Diaphragm eventration
  • Kyphoscoliosis
  • Narrow mesenteric base
    • The midgut becomes suspended by a narrow pedicle.
  • Non-rotation
    • In non-rotation, the primary loop undergoes no further rotation during its return to the abdominal cavity.
    • The small bowel becomes located on the right whilst the colon is on the left of the abdomen.
    • Non-rotation is less dangerous than malrotation because in non-rotation, the mesentery is wider and the risk of volvulus is lower.
  • Malrotation
    • In malrotation, the proximal (duodenojejunal) limb remains in a position of non-rotation, and the distal (cecocolic) limb partially rotates (usually only 90 degrees instead of 180 degrees).

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