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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 infants and children.
Volvulus occurs due to failure of the fetal gut to undergo normal in utero rotation and fixation (malrotation), resulting in a narrow mesenteric vascular pedicle.
Up to 30% of children with malrotation have congenital heart disease. Additionally, 30–60% of patients with other congenital gastrointestinal (GI) malformations (gastroschisis, omphalocele, intestinal atresia, Hirschsprung disease) have malrotation.