Volvulus is a topic covered in the Select 5-Minute Pediatrics Topics.

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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.


  • Malrotation with midgut volvulus occurs in 1 in 6,000 live births.
  • Slightly more common in boys
  • Most children with midgut volvulus present in the 1st month of life.

Risk Factors

  • Children with malrotation have a narrow mesenteric vascular pedicle and are predisposed to volvulus.
  • Familial associations can occur.
  • The risk of volvulus in patients with malrotation does not decrease with age.


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.

Commonly Associated Conditions

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.

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