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Asian Journal of Surgery Jan 2022Sigmoid volvulus is the most common type of volvulus. Its epidemiological features, as well as its management, differ between developed and developing countries. This...
BACKGROUND/OBJECTIVE
Sigmoid volvulus is the most common type of volvulus. Its epidemiological features, as well as its management, differ between developed and developing countries. This work aims to analyze the epidemiological features thus allowing to compare them to the rest of the "volvulus belt'' and assess the surgical management of sigmoid volvulus in Tunisia.
METHOD
This is a retrospective review of 64 patients with sigmoid volvulus treated in the General Surgery department of Jendouba Hospital. January 2005-December 2019.
RESULTS
64 patients were treated for acute sigmoid volvulus. The sex ratio male to female ratio was 5.4/1 with male predominance. 5.4:1 (54 males to 10 females). The mean age was 62 years. The classic triad of intestinal occlusion was reported in 56 patients. The mean duration of symptoms was 4.2 days. An accurate preoperative diagnosis was made in 58 cases. Forty patients had a viable bowel obstruction, and all of them had a resection and primary anastomosis. Sixteen patients had a gangrenous bowel obstruction, of which 6 patients had resection-primary anastomosis, and 10 had Hartmann's procedure. Out of the total five deaths reported, there were only two among patients who had resection-primary anastomosis for gangrenous bowel obstruction. The most common postoperative complication was wound infections in 5 cases. The median length of hospital stay following surgery was 8 days. No recurrences of volvulus after a median follow-up of 11 months.
CONCLUSIONS
Although Tunisia belongs to the volvulus belt, the epidemiologic features of sigmoid volvulus tend rather be similar to those of developed countries. The use of primary surgery, if no endoscopy is performed, is a good alternative. For patients who have contraindications for endoscopic treatment, surgical treatment is the only option.
Topics: Colostomy; Female; Humans; Intestinal Obstruction; Intestinal Volvulus; Male; Middle Aged; Retrospective Studies; Sigmoid Diseases
PubMed: 33895046
DOI: 10.1016/j.asjsur.2021.04.004 -
Pediatric Radiology Jul 2016Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require... (Review)
Review
Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require elective surgical correction, but the potential of malrotation with midgut volvulus demands prompt imaging evaluation. We review the various causes of congenital duodenal obstruction with an emphasis on the approach to imaging evaluation and diagnosis.
Topics: Child; Constriction, Pathologic; Diagnostic Imaging; Duodenal Obstruction; Humans; Intestinal Volvulus
PubMed: 27324508
DOI: 10.1007/s00247-016-3603-1 -
Acta Paediatrica (Oslo, Norway : 1992) Jun 2016Our aim was to assess if term and preterm infants with volvulus showed different patterns with regard to pathogenesis, clinical presentation and outcome.
AIM
Our aim was to assess if term and preterm infants with volvulus showed different patterns with regard to pathogenesis, clinical presentation and outcome.
METHODS
We reviewed the medical records and imaging data of infants aged less than six months with volvulus treated in a single surgical referral centre from 2006-2013.
RESULTS
Volvulus was diagnosed in 19 infants, with no anatomical anomaly in three of the 12 preterm infants and one of the seven term infants. Most cases (74%) presented during the first eight days of life. Later presentations occurred exclusively in preterm infants, with only one of the five having no anatomic anomalies. Bilious vomiting was the leading symptom in six of the seven term infants, while the symptoms in preterm infants were rather nonspecific. Intestinal necrosis, with the need for bowel resection, occurred in one term (14%) infant and nine (75%) preterm infants.
CONCLUSION
The clinical presentation and outcome of volvulus differed between preterm and term infants, but the rate and distribution of underlying anomalies did not differ. Symptoms in preterm infants were often nonspecific and led to a delay in diagnosis. This might have contributed to the higher rate of intestinal necrosis in preterm infants.
Topics: Female; Humans; Infant; Infant, Newborn; Infant, Premature; Intestinal Volvulus; Male; Radiography, Abdominal; Retrospective Studies
PubMed: 26991742
DOI: 10.1111/apa.13403 -
BMJ Case Reports Mar 2021Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop...
Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis. Here, we present a single-centre case series of two patients presenting with caecal volvulus to an Emergency Surgery Unit at a University Hospital.
Topics: Cecal Diseases; Humans; Intestinal Obstruction; Intestinal Volvulus; Ischemia
PubMed: 33692042
DOI: 10.1136/bcr-2020-237165 -
Surgery Aug 2016
Topics: Aged, 80 and over; Humans; Intestinal Volvulus; Male; Sigmoid Diseases
PubMed: 26805945
DOI: 10.1016/j.surg.2015.12.011 -
The American Surgeon Dec 2023
Topics: Humans; Intestinal Volvulus; Digestive System Surgical Procedures; Retrospective Studies
PubMed: 36031935
DOI: 10.1177/00031348221124322 -
Pediatrics International : Official... Nov 2016The aim of this study was to evaluate clinical presentation, diagnostic studies, and volvulus rate and to describe the unusual clinical clues of intestinal malrotation.
BACKGROUND
The aim of this study was to evaluate clinical presentation, diagnostic studies, and volvulus rate and to describe the unusual clinical clues of intestinal malrotation.
METHODS
A retrospective descriptive review was carried out of all patients diagnosed with intestinal malrotation between 2002 and 2014. Patients were divided into two groups: infants (≤1 year, n = 16; group 1); and children (>1 year, n = 12; group 2). Patient demographics, clinical history, symptoms, physical examination, diagnostic work-up, operative findings and early outcome were evaluated.
RESULTS
Bilious vomiting was the cardinal complaint in both groups. Unusual symptoms such as respiratory insufficiency, dehydration, afebrile convulsion, and lethargy were prominent symptoms in six patients in group 1, whereas history of frequent hospitalization due to recurrent abdominal pain and feeding intolerance were prominent in six patients in group 2. Midgut volvulus was identified in 15 patients, four of whom were in group 2. Standard Ladd's procedure was done in addition to correction of volvulus.
CONCLUSION
Malrotation with or without midgut volvulus is not a rare condition and should be kept in mind for any age group. Specific signs of diagnosis are not easily identified. In the case of unusual clinical presentation, diagnosis may be delayed and can result in catastrophic consequences if intestinal perfusion occurs. Although midgut volvulus is seen most frequently in infants, risk and complication rate are high beyond 1 year of age as well, and can manifest as failure to thrive, food intolerance, and abdominal pain needing recurrent hospitalization. Diagnostic suspicion and interdisciplinary coordination are essential for timely diagnosis and surgical treatment.
Topics: Adolescent; Child; Child, Preschool; Decision Making; Digestive System Abnormalities; Digestive System Surgical Procedures; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Intestinal Volvulus; Male; Radiography, Abdominal; Retrospective Studies; Time Factors; Tomography, X-Ray Computed; Ultrasonography, Doppler
PubMed: 27353636
DOI: 10.1111/ped.13075 -
The British Journal of Surgery Nov 2020
Topics: Abdominal Pain; Aged, 80 and over; Colon, Sigmoid; Humans; Intestinal Volvulus; Laparotomy; Male
PubMed: 33280105
DOI: 10.1002/bjs.12006 -
Archives of Disease in Childhood. Fetal... Jul 2019We conducted a monthly epidemiological survey in Germany to detect the prevalence of volvulus without malrotation (VWM) in very low birthweight (VLBW) infants and to...
BACKGROUND
We conducted a monthly epidemiological survey in Germany to detect the prevalence of volvulus without malrotation (VWM) in very low birthweight (VLBW) infants and to identify factors for a better distinction between this rare and life-threatening event and other acute abdominal diseases in preterm infants.
METHODS
Throughout 2014 and 2015, every paediatric department in Germany was asked to report cases of VWM in infants with birth weights <1500 g to the Surveillance Unit for Rare Paediatric Conditions in Germany. Hospitals reporting a case were asked to return an anonymised questionnaire and discharge letter.
RESULTS
Of 36 cases reported, detailed information was submitted on 29, with 26 meeting entry criteria. With 9896 and 10 140 VLBW infants born in Germany in 2014 and 2015, respectively, we estimated a prevalence of 1.52/1000 VLBW infants for 2014 and 1.08/1000 in 2015. No specific early symptom could be determined. 10% died, and 21% of infants developed short bowel syndrome. Calculated from all verified VWM arise death in 8% and a short bowel syndrome in 15%.
CONCLUSION
VWM is a rare source of acute abdomen in VLBW infants. No specific signs and symptoms potentially facilitating an early recognition of VWM could be found from this survey. Because the rates of death and short bowel syndrome are high, VWM should always be considered early in an acute abdomen in a VLBW infant.
Topics: Abdomen, Acute; Female; Germany; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Intestinal Obstruction; Intestinal Volvulus; Male; Prevalence
PubMed: 30262462
DOI: 10.1136/archdischild-2018-315282 -
Ginekologia Polska 2022To investigate the clinical significance of prenatal diagnosis and prognostic evaluation of fetal intestinal malrotation with midgut volvulus via ultrasonography.
OBJECTIVES
To investigate the clinical significance of prenatal diagnosis and prognostic evaluation of fetal intestinal malrotation with midgut volvulus via ultrasonography.
MATERIAL AND METHODS
Ultrasonographic findings and clinical outcomes of fetal intestinal malrotation with midgut volvulus prenatally diagnosed via ultrasound at the Zhangzhou Hospital Affiliated of Fujian Medical University from January 2013 to May 2020 were summarised and analyzed.
RESULTS
Eleven cases of fetal intestinal malrotation with midgut volvulus were accurately prenatally diagnosed according to the specific ultrasound signs, such as 'whirlpool sign' and 'twining sign'. Indirect and nonspecific ultrasonographic signs included ascites in four cases and echogenic bowel in nine, all of which were accompanied by intestinal dilatation at various degrees. Among all cases, two were complicated with other system abnormalities, and one had a chromosome abnormality. Three pregnant women chose termination of pregnancy, and eight neonates were transferred to the pediatric department for surgery after obtaining written informed consent. An accurate prenatal diagnosis was confirmed postoperatively, and the fetus recovered well postoperatively.
CONCLUSION
S: : Fetal intestinal malrotation with midgut volvulus has typical sonographic features, and ultrasonography is the method of choice for prenatal diagnosis of this disease. Fetal intestinal malrotation with midgut volvulus is a non-fatal congenital malformation that can be treated. Prenatal diagnosis is essential for early postnatal treatment, and early surgery can often obtain good efficacy and prognosis.
Topics: Infant, Newborn; Child; Humans; Female; Pregnancy; Intestinal Volvulus; Ultrasonography; Digestive System Abnormalities; Fetus
PubMed: 35156693
DOI: 10.5603/GP.a2021.0237