Male1: Sometimes, a baby vomits and everybody is thinking about reflux reflex and she gets better and it comes back and they do some x-rays, they say it is like volvulus, what is a volvulus?
Male2: Volvulus is one of the most serious conditions that can befall a baby’s intestines. It is life threatening and it is one of the first things a pediatric surgeon thinks about. Not because it is the most common, but because it is catastrophic--
Male1: You do not want to miss it.
Male2: Delay and that means that the bowels are twisted on their blood supply, completely twisted. A volvulus is an abnormal twisting and that can lead to--
Male1: So normally they have got—it is held in a certain position and somehow this is floating around?
Male2: Yes because all of these things relate to what is going on in utero and the baby is being formed and embryo are developing and most of us, our bowels are anchored all in a large expanse, diagonally across the abdomen, so the stomach empties into the duodenum and the first part of the small bowel is way up here. The last part of that digestive system is way down here and that anchor would not allow a twist, but if the bowels do not fix that way in utero, if they remain on a little narrow pedicle, a little narrow stalk, they can suddenly twist, so the baby is born with something called malrotation which lives them at lifelong risk of volvulus and if we recognize that the baby has malrotation, we perform an operation to make that unlikely.
Male1: So you have to make sure that the bowel cannot rotate, it could have done it someway.
Male2: So it does not twist, yes sir.
Male1: And once you do a surgery, you are done with this, is that correct?
Male2: Most of the time.
Male1: Unless there is some other thing, maybe—one thing is going wrong, there could be some other things going on.
Male2: Yes and anytime they have an operation, you need to be alerted, you can get obstructions in the future, you could even get a recurrent volvulus after that type of operation, but it is not likely.
Male1: But a good follow up is very important?
Male2: Yes.
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