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Emergency Medicine8 papers

Torsion of intestine

Last edited: 4/16/2026

Overview

Intestinal torsion, also known as volvulus, involves the twisting of the intestine on its mesentery, leading to compromised blood supply and potential necrosis if not promptly addressed. 1

Diagnosis

  • Clinical Presentation: Nausea, vomiting, and abdominal pain are common but can mimic obstetric or surgical emergencies in pregnant women 1.
  • Diagnostic Challenges: Atypical abdominal signs in pregnancy complicate early diagnosis; radiological imaging carries risks due to potential fetal harm 1.
  • Limited Utility of Imaging: Ultrasound and CT scans are constrained by maternal anatomy and fetal safety concerns, potentially leading to missed diagnoses 1.

    • Management

  • Surgical Intervention: Prompt surgical exploration and detorsion are critical; resection may be necessary if bowel necrosis is present 1.
  • Conservative Management: Not typically applicable; surgical intervention is generally required due to the severity of the condition 1.

    • Special Populations

  • Pregnancy: Diagnosis is particularly challenging due to atypical presentations and risks associated with imaging; consider intestinal torsion in differential diagnosis despite complexities 1.

    • Key Recommendations

  • Consider intestinal torsion in the differential diagnosis of abdominal pain in pregnant women, especially when atypical symptoms are present (Evidence: Weak 1).
  • Exercise caution with radiological imaging in pregnant patients due to potential fetal risks; prioritize non-invasive diagnostic approaches when possible (Evidence: Weak 1).
  • Initiate urgent surgical evaluation and intervention for suspected intestinal torsion to prevent bowel necrosis and improve outcomes (Evidence: Expert opinion 1).

    • References

    1 Zhang Y, Chi S. A rare case of small intestine torsion in pregnancy. Asian journal of surgery 2023. link

    Original source

    1. [1]
      A rare case of small intestine torsion in pregnancy. — Zhang Y, Chi S Asian journal of surgery (2023)
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