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Journal of Medical Case Reports Oct 2021Gallbladder volvulus is a rare pathology first reported by Wendel in 1898. Although the main pathological process associated with gallbladder volvulus is not known,...
BACKGROUND
Gallbladder volvulus is a rare pathology first reported by Wendel in 1898. Although the main pathological process associated with gallbladder volvulus is not known, there is clinical evidence suggesting that lack of gallbladder adhesions to the liver leads to an eventual twisting around the cystic bile duct (a process that seems to favor older female populations).
CASE PRESENTATION
In this report, an 81-year-old Caucasian elderly female presented to the emergency department with acute/severe right upper quadrant pain, which was also accompanied by an elevated leukocyte count. Relevant imaging showed a distended gallbladder with gallbladder wall thickening and a dilated common bile duct. The patient was subsequently admitted to the hospital for acute cholecystitis and scheduled for surgery the next day. Upon laparoscopic surgery, the gallbladder was black and gangrenous with no visible adhesions to the liver. Further inspection demonstrated that the gallbladder had twisted clockwise around the cystic bile duct.
CONCLUSIONS
While many previous cases have been reported since Wendel, further case studies are nevertheless important to help guide proper clinic evaluation and pinpoint the potential for a gallbladder volvulus.
Topics: Abdominal Pain; Aged; Aged, 80 and over; Female; Gallbladder Diseases; Humans; Intestinal Volvulus; Torsion Abnormality
PubMed: 34625099
DOI: 10.1186/s13256-021-03115-7 -
The American Surgeon Jun 2022
Topics: Adult; Digestive System Abnormalities; Humans; Intestinal Volvulus
PubMed: 32902301
DOI: 10.1177/0003134820947406 -
The Canadian Veterinary Journal = La... Mar 2024To describe the findings, treatment, and outcome of small intestinal volvulus (SIV) in 47 cows.
OBJECTIVE
To describe the findings, treatment, and outcome of small intestinal volvulus (SIV) in 47 cows.
ANIMALS AND PROCEDURE
Retrospective analysis of medical records. Comparison of the findings for 18 surviving and 29 non-surviving cows.
RESULTS
The most common abnormal vital signs were tachycardia (68.0%), tachypnea (59.6%), and decreased rectal temperature (51.1%). Signs of colic occurred in 66.0% of cows in the study. Rumen motility was reduced or absent in 93.6% of cows, and intestinal motility in 76.6%. Clinical signs on ballottement and/or percussion and simultaneous auscultation were positive on the right side in 78.7% of cows. Transrectal examination showed dilated small intestines in 48.9% of cows. The rectum contained little or no feces in 93.6% of cows. The principal laboratory abnormalities were hypocalcemia (74.1%), hypokalemia (73.8%), azotemia (62.8%), hypermagnesemia (61.6%), and hemoconcentration (60.0%). The principal ultrasonographic findings were dilated small intestines (87.1%) and reduced or absent small intestinal motility (85.2%). Forty-one of the 47 cows underwent right flank laparotomy and the SIV was reduced in 21 cows. When comparing the clinical and laboratory findings of 18 surviving and 29 non-surviving cows, the groups differed significantly with respect to severely abnormal general condition (16.7 37.9%), rumen stasis (22.2 79.3%), intestinal atony (16.7 48.3%), serum urea concentration (6.5 9.8 mmol/L), and serum magnesium concentration (0.98 1.30 mmol/L). In summary, 38.3% of the cows were discharged and 61.7% were euthanized before, during, or after surgery.
CONCLUSION AND CLINICAL RELEVANCE
An acute course of disease, little or no feces in the rectum, and dilated small intestines were characteristic of SIV in this study population.
Topics: Humans; Female; Cattle; Animals; Pregnancy; Intestinal Volvulus; Retrospective Studies; Intestine, Small; Rectum; Feces; Magnesium; Cattle Diseases
PubMed: 38434172
DOI: No ID Found -
Abdominal Radiology (New York) Sep 2018Intestinal malrotation is a continuum of congenital anomalies due to lack of rotation or incomplete rotation of the fetal intestine around the superior mesenteric artery... (Review)
Review
Intestinal malrotation is a continuum of congenital anomalies due to lack of rotation or incomplete rotation of the fetal intestine around the superior mesenteric artery axis. The abnormal bowel fixation (by mesenteric bands) or absence of fixation of portions of the bowel increases the risk of bowel obstruction, acute or chronic volvulus, and bowel necrosis. The clinical presentation of patients with malrotation without, with intermittent, or with chronic volvulus can be problematic, with an important minority presenting late or having atypical or chronic symptoms, such as intermittent vomiting, abdominal pain, duodenal obstruction, or failure to thrive. The diagnosis is heavily reliant on imaging. Upper GI series remain the gold standard with the normal position of the duodenojejunal junction lateral to the left-sided pedicles of the vertebral body, at the level of the duodenal bulb on frontal views and posterior (retroperitoneal) on lateral views. However, a variety of conditions might influence the position of the duodenojejunal junction, potentially leading to a misdiagnosis of malrotation. Such conditions include improper technique, gastric over distension, splenomegaly, renal or retroperitoneal tumors, liver transplant, small bowel obstruction, the presence of properly or malpositioned enteric tubes, and scoliosis. All of these may cause the duodenojejunal junction to be displaced. We present a series of cases highlighting conditions that mimic malrotation without volvulus to increase the practicing radiologist awareness and help minimize interpretation errors.
Topics: Diagnosis, Differential; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Intestinal Volvulus; Radiography, Abdominal
PubMed: 29500650
DOI: 10.1007/s00261-018-1537-9 -
Revista Medica Del Instituto Mexicano... Aug 2022Cecal volvulus is a rare disease that causes intestinal obstruction. It has various congenital and acquired risk factors. It is frequently associated with abnormal cecal... (Review)
Review
BACKGROUND
Cecal volvulus is a rare disease that causes intestinal obstruction. It has various congenital and acquired risk factors. It is frequently associated with abnormal cecal fixation, and it is caused by torsion of the cecum in one of its three axes. It is not different from other causes of intestinal obstruction, but a delay in its diagnosis can lead to ischemia, necrosis and colon perforation. Its management depends on the viability of the tissues, ranging from untwisting and cecopexy to hemicolectomy with or without anastomosis. We present a case of caecal volvulus (caecal bascule) and review the literature as well.
CLINICAL CASE
43-year-old female, who was admitted to an emergency department with data of intestinal obstruction. A simple tomography of the abdomen was performed, where a dilated colon and an image that resembles an inverted coffee bean were identified. An exploratory laparotomy was performed, identifying a bascule-type cecal volvulus, without vascular compromise. Devolvulation, decompression through appendectomy, and caecopexy were performed. After the surgical event, the patient recovered without incident and was discharged with adequate controls by external consultation.
CONCLUSIONS
Cecal volvulus is a cause of intestinal obstruction with a low incidence, which is why early recognition and treatment are key to avoiding the complications that its evolution entails. This type of disease should be among our differential diagnoses, since treatment is surgical and delay leads to a high mortality rate.
Topics: Adult; Appendectomy; Cecal Diseases; Colectomy; Female; Humans; Intestinal Obstruction; Intestinal Volvulus
PubMed: 36049083
DOI: No ID Found -
Rozhledy V Chirurgii : Mesicnik... 2023Bariatric surgery is a widespread branch of surgery because of the increase in obesity in population. It is one way to achieve long-term weight loss effect in obese...
INTRODUCTION
Bariatric surgery is a widespread branch of surgery because of the increase in obesity in population. It is one way to achieve long-term weight loss effect in obese patients. Like other surgeries, bariatric surgery has many complications including ileus and volvulus in small intestine. It is an acute state in surgery and usually leads to a revision surgery.
CASE REPORT
58 years old woman who underwent mini-gastric bypass in 2014. She was admitted to our department because of manifestation of ileus on the second day after TEP of the hip joint. There was a typical sign of volvulus on the CT scan. She was operated on the same day. The reinsertion of enteroenteroanastomosis and denotation of the small intestine, desufflation of the large intestine, and reconstruction of new enteroenteroanastomosis was needed. After the surgery, the patient was without any complications. The bowel function recovery was slower postoperatively.
CONCLUSION
Diagnosis of volvulus is not easy because of non-specific clinical symptoms. In this case report, the volvulus occurred 8 years after the primary surgery. Symptoms developed because of paralytic ileus after hip replacement.
Topics: Female; Humans; Middle Aged; Intestinal Volvulus; Bariatric Surgery; Gastric Bypass; Obesity; Intestinal Obstruction; Ileus; Obesity, Morbid
PubMed: 37344209
DOI: 10.33699/PIS.2023.102.3.139-141 -
The Canadian Veterinary Journal = La... Jul 2022A 6-year-old neutered male golden retriever mix dog was presented for investigation of acute restlessness, increased respiratory effort, non-productive retching, and...
A 6-year-old neutered male golden retriever mix dog was presented for investigation of acute restlessness, increased respiratory effort, non-productive retching, and anorexia. Initial abdominal radiography revealed marked gastric dilation with a normal gastric shape and position, along with mineralized granular material in the pyloric region, consistent with a pyloric outflow obstruction secondary to suspected sand impaction. The dog was stabilized with gastric trocharization and medical management with intravenous fluids, antiemetics, polyethylene glycol a nasogastric tube, and analgesia was initiated. The dog developed aspiration pneumonia during hospitalization and became oxygen-dependent. There was no significant improvement of clinical status despite 72 h of medical management, and surgical intervention was subsequently recommended. Exploratory laparotomy revealed a counterclockwise gastric dilatation and volvulus. The stomach was repositioned into normal anatomic position and an incisional gastropexy was performed. The dog was maintained in the intensive care unit for 4 d postoperatively. Currently, 3 mo postoperatively, the dog is healthy without recurrence of clinical signs. Key clinical message: Counterclockwise gastric dilatation and volvulus is a rare condition in veterinary medicine; however, it should be considered in a patient with acute gastric distension and signs of pyloric outflow obstruction when characteristic radiological signs of clockwise gastric dilatation and volvulus are absent, and there is radiological evidence of persistent gastric foreign material despite medical management. Misdiagnosis of counterclockwise gastric dilatation and volvulus can delay definitive surgical intervention and lead to higher morbidity and mortality.
Topics: Animals; Dog Diseases; Dogs; Gastric Dilatation; Gastropexy; Intestinal Volvulus; Male; Stomach Volvulus
PubMed: 35784770
DOI: No ID Found -
The American Surgeon Nov 2023Duodenum inversum, or inverted duodenum, is a rare congenital disorder resulting in an abnormal position of the third and/or fourth portions of the duodenum. Most...
Duodenum inversum, or inverted duodenum, is a rare congenital disorder resulting in an abnormal position of the third and/or fourth portions of the duodenum. Most patients are asymptomatic, but others can experience pain, nausea, vomiting, peptic ulcer disease, pancreatitis, and even intestinal obstruction. In this case, we report a patient who presented with acute abdominal pain and vomiting. He was diagnosed with duodenal volvulus and obstruction due to duodenum inversum. After failing nonoperative management, the patient was successfully treated with surgical resection.
Topics: Male; Humans; Intestinal Volvulus; Duodenum; Duodenal Obstruction; Abdominal Pain; Vomiting
PubMed: 33861662
DOI: 10.1177/00031348211011111 -
The Journal of Emergency Medicine Oct 2020
Topics: Humans; Intestinal Obstruction; Intestinal Volvulus; Intestine, Small
PubMed: 32771322
DOI: 10.1016/j.jemermed.2020.06.067 -
Journal of Pediatric Surgery Jun 2017Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11)...
BACKGROUND/PURPOSE
Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis.
METHODS
This was an institutional review board approved single-institution retrospective chart review of 11 cases of large bowel volvulus occurring over 15 years (2000-2015).
RESULTS
In our series, the most common presenting symptoms were abdominal pain and distention. Afflicted patients often had prior abdominal surgery, a neurodevelopmental disorder or chronic constipation. Of the imaging modalities utilized in the 11 patients studied, colonic volvulus was correctly diagnosed by barium enema in 100% of both cases, CT in 55.6% of cases and by plain radiography of the abdomen in only 22.2%of cases. Colonic volvulus was confirmed by laparotomy in all cases. The cecum (n=5) was the most often affected colonic segment, followed by the sigmoid (n=3). Operative treatment mainly consisted of resection (63.6%) and ostomy creation (36.4%). Colopexy was performed in 18.2% of cases.
CONCLUSIONS
Plain abdominal radiography may be performed as an initial diagnostic study, however, it should be followed CT or air or contrast enema in children where there is high clinical suspicion and who do not have indications for immediate laparotomy. CT may be the most specific and useful test in diagnosis of colonic volvulus and has the added advantage of detection of complications including bowel ischemia. We demonstrate a range of diagnostic and therapeutic modalities for pediatric colonic volvulus. This underscores the need for further study to draft standard best practices for this life-threatening condition.
LEVEL OF EVIDENCE
Prognosis Study: Level IV. Study of a Diagnostic Test: Level III.
Topics: Adolescent; Child; Child, Preschool; Colectomy; Colonic Diseases; Colostomy; Female; Humans; Infant; Intestinal Volvulus; Male; Prognosis; Radiography, Abdominal; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed
PubMed: 28202185
DOI: 10.1016/j.jpedsurg.2017.01.063