fatal “knot”

This is the 4015 article

of Medical Care

Xiao A has recently become obsessed with basketball, and spends almost all of his spare time to study techniques, not only practicing on the way to and from school, but also during the lunch break between classes. No, he just finished the buffet on the weekend, and he was catching up with his friends to make an appointment, and quickly changed his equipment to participate. He also knew that strenuous exercise should not be done after a full meal, so he prepared to practice casually. I don’t know how good the hand feels on this day, and I devote myself to the practice. Dribble, turn, jump, dunk! So cool! But…why does it hurt the more I hit my stomach? No way, the young man called for a substitution and went to the sidelines to drink some water and rest. But who knows that the abdominal pain is getting more and more severe, especially around the belly button, and the pain even radiates to the lower back, Xiao A looks pale, bows his head and vomits! The friends sent him to the hospital with all kinds of hands and feet. Only through the examination did they find that it was “intestinal knot”, also known as volvulus, and if he went to the doctor later, it might endanger his life!

Why is ‘gut knot’ deadly?

Intestinal volvulus is an intestinal obstruction caused by the twisting of a segment of intestinal loop and its mesentery along the mesenteric axis by more than 180 degrees. Due to the different rotation angles of the intestinal lumen, both ends of the intestinal lumen will be compressed. produce varying degrees of clinical symptoms. The main symptoms are abdominal pain, bloating, nausea, and vomiting.

The “intestinal knot” is a severe volvulus with a large rotation angle, and the condition is dangerous and serious. Not only will it cause obstruction of the bowel, but also the blood circulation of the mesentery will be interrupted, resulting in blood stasis, edema and necrosis of the intestinal wall, which becomes very fragile. Once the pressure of the intestinal cavity increases and the expansion occurs, the intestinal wall is prone to intestinal perforation, and the intestinal contents will spread into the abdominal cavity, causing acute peritonitis. In severe cases, electrolyte and acid-base balance disorders and even toxic shock may occur. It is a dangerous and rapidly developing type of intestinal obstruction, and the mortality rate is as high as 15-20%.

The onset of volvulus often presents as severe abdominal pain with no intermittent periods, and shock can occur in the early stage, which is life-threatening. Therefore, once a volvulus is suspected, it should be sent to a doctor immediately. Most of the causes of death of volvulus patients are caused by untimely treatment.

What are the main symptoms of volvulus?

Our bowel can be divided into three main segments, the small intestine, the large intestine and the rectum. They are curved and arranged in an orderly manner in the abdominal cavity. volvulus mainly occurs in the small intestine and the cecum and sigmoid colon of the large intestine, and volvulus in different parts will have different clinical manifestations.

Small bowel volvulus

Most common and often occurs in young and middle-aged male manual workers. There was a history of overeating and strenuous activity before the onset of symptoms. Mostly manifested as sudden umbilical colic, which can radiate to the lower back, accompanied by vomiting.

Sigmoid volvulus

It is more common in older men. History of protracted sigmoid colon or constipation. It manifested as persistent abdominal pain, and left abdominal distention was obvious.

cecal volvulus

Rare and may manifest as abdominal pain, vomiting, and right lower quadrant mass.

What causes “knotted intestines”?

The causes of volvulus include anatomical, physical, and dynamic factors.

Anatomical factors

Mainly including postoperative adhesions and various intestinal surgical diseases.

Physical Factors

Including full meal, roundworm mass, tumor, dry stool caused by constipation, etc.

Dynamic Factor

A sudden change in the patient’s position.

For example, Xiao A’s disease this time was caused by strenuous exercise after a full meal. As soon as the young man heard about the need for surgery, he quickly asked the doctor, “Can I take medicine instead of surgery? Otherwise, I won’t be able to play for a long time.” The doctor could only shake his head after hearing this. No effective oral drug for volvulus has been developed yet. Once diagnosed as volvulus, hospitalization must be done promptly. “Boy, is the ball more important or life more important?”

Intestinal volvulus is mainly treated by surgery, and timely surgery has a significant impact on prognosis. In addition to surgery, strict fasting is also required, and electrolytes, acid-base balance need to be maintained, and anti-infective treatment is required if necessary.

How to prevent deadly “knotted intestines”?

Develop healthy eating and living habits and check regularly:

1. Avoid overeating, eat less raw, cold and spicy food to reduce the burden on the stomach;

2. Avoid heavy physical exertion, strenuous exercise, especially activities that require bending and spinning immediately after a full meal. better offAfter half an hour to an hour of rest, exercise gently, and then gradually increase the amount of exercise scientifically.

3. Regular physical examinations to prevent intestinal diseases. Once symptoms related to volvulus appear, such as abdominal pain, bloating, nausea, vomiting, etc., do not blindly take painkillers by yourself, so as not to cover up the condition and delay treatment, you must seek medical attention in time.

Author: East China Sanatorium

Zhou Lu