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Asian Journal of Surgery Nov 2023
Topics: Humans; Child; Intestinal Volvulus; Colon, Transverse; Intestinal Obstruction; Colonic Diseases
PubMed: 37301619
DOI: 10.1016/j.asjsur.2023.05.143 -
Journal of the Korean Society of... Jan 2024Malrotation and midgut volvulus are surgical emergencies that commonly occur within the first month of life. The classic symptom is acute bilious vomiting, while... (Review)
Review
Malrotation and midgut volvulus are surgical emergencies that commonly occur within the first month of life. The classic symptom is acute bilious vomiting, while nonspecific symptoms such as recurrent abdominal pain may be present in older children. Malrotation can be associated with duodenal obstruction caused by an abnormal peritoneal fibrous band or congenital anomalies, such as an annular pancreas or a preduodenal portal vein. Volvulus can lead to bowel ischemia and a life-threatening condition, thus prompt and accurate diagnosis is crucial. Diagnosis can be made through upper gastrointestinal series, ultrasonography, and CT, with ultrasonography being preferred as a screening tool due to its rapid and accurate diagnosis, without radiation exposure, in children. This pictorial essay discusses the key imaging findings and diagnostic approaches for malrotation and midgut volvulus, as well as diagnostic pitfalls based on actual cases.
PubMed: 38362395
DOI: 10.3348/jksr.2023.0002 -
Journal of Perinatology : Official... May 2024Our objective is to analyse the observations related to intrauterine volvulus and assess how clinical manifestations and treatment strategies impact prognosis. We... (Review)
Review
Our objective is to analyse the observations related to intrauterine volvulus and assess how clinical manifestations and treatment strategies impact prognosis. We conducted a comprehensive search on Pubmed and ClinicalTrials.gov from inception to July 2022, using search terms like "intrauterine volvulus" or "foetal volvulus," supplemented by manual scrutiny of reference lists in relevant texts and articles. Our review encompassed 57 case reports/case series, involving 88 cases. The presence of foetal bradycardia during prenatal visits (p = 0.002) and the existence of meconium cyst or pseudocyst (p = 0.038) significantly influence survival rates. Preterm labour occurred more frequently among cases resulting in mortality (54% vs 21%; p = 0.055). Our study's limitations include the inability to access all reported cases and reliance solely on available data. We advocate for vigilant monitoring of foetuses exhibiting signs of intestinal obstruction, and consideration of an emergent caesarean section as a pre-emptive measure before foetal biophysical profile deterioration worsens.
PubMed: 38704480
DOI: 10.1038/s41372-024-01984-6 -
ANZ Journal of Surgery Nov 2023
Topics: Humans; Stomach Volvulus; Liver Diseases; Ischemia
PubMed: 37727040
DOI: 10.1111/ans.18702 -
Case Reports in Surgery 2023A gallbladder torsion typically presents as an acute abdomen presentation with nonspecific clinical signs. When not detected by a clinician preoperatively, it can lead...
BACKGROUND
A gallbladder torsion typically presents as an acute abdomen presentation with nonspecific clinical signs. When not detected by a clinician preoperatively, it can lead to the delay of emergency surgery and possible misdiagnosis for other, more common causes of an acute abdomen. . We report the case of acute gallbladder volvulus in an 80-year-old woman complaining of constant pain in the right upper quadrant of the abdomen.
CONCLUSIONS
The patient was successfully treated with cholecystectomy. The case highlights the high index of suspicion required to diagnose the condition preoperatively in this population of patients to reduce complications such as biliary peritonitis and death.
PubMed: 37941826
DOI: 10.1155/2023/1194077 -
Revista Espanola de Enfermedades... Sep 2023"Bariolith" is defined as the concretion of barium sulfate in the intestine after performing a radiological study with said contrast. Complications derived from the use...
"Bariolith" is defined as the concretion of barium sulfate in the intestine after performing a radiological study with said contrast. Complications derived from the use of barium are exceptional, but appendicitis, intussusception, volvulus, ulceration, ischemia and perforation have been described. We present the case of a 62 years old woman, who underwent a EGD exploration on the 15th of January 2021 as a part of her study for suspected GERD.
Topics: Humans; Female; Middle Aged; Intestinal Obstruction; Barium Sulfate; Intussusception; Intestinal Volvulus; Appendicitis
PubMed: 36043557
DOI: 10.17235/reed.2022.9084/2022 -
ACG Case Reports Journal Oct 2023Small intestinal lipomatosis is a rare condition with a poorly understood epidemiology and pathophysiology. Cases of small intestinal lipomatosis have been documented in...
Small intestinal lipomatosis is a rare condition with a poorly understood epidemiology and pathophysiology. Cases of small intestinal lipomatosis have been documented in multiple countries over the last century, yet little has been published regarding the natural history of this disease. Therapeutic options are largely surgical and based on limited evidence. We report a unique case of diffuse jejunal lipomatosis in a 62-year-old man with complications of small bowel obstruction, small bowel volvulus, jejunal diverticulosis, pneumatosis intestinalis, malnutrition, small intestinal bacterial overgrowth, and intestinal dysmotility developing over a 12-year period.
PubMed: 37860810
DOI: 10.14309/crj.0000000000001179 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Oct 2023Internal hernias involve the herniation of intestines through mesenteric or peritoneal defects in the gastrointestinal system. Etiologically, they are generally... (Observational Study)
Observational Study
BACKGROUND
Internal hernias involve the herniation of intestines through mesenteric or peritoneal defects in the gastrointestinal system. Etiologically, they are generally classified as congenital or acquired. Internal hernias often present with non-specific symptoms. Despite the increased use of computed tomography (CT), discrepancies between imaging findings and diagnostic accuracy continue to pose challenges for clinicians. This study aims to compare the outcomes of patients presenting to the emergency department with abdominal pain and receiving a preliminary internal hernia diagnosis through CT, followed by laparotomy.
METHODS
Our research is a retrospective, observational, and descriptive study. It includes patients presenting to the emergency department with abdominal pain, who were provisionally diagnosed with internal hernia based on CT. Patient data recorded age, gen-der, CT-identified internal hernia type, surgery, diagnoses, hospitalization status, duration of hospital stay, bowel resection, mortality, and blood parameters. The Welch classification was used to categorize internal hernia types, with eight types examined.
RESULTS
Among 112 patients with a preliminary internal hernia diagnosis based on abdominal CT, the median age was 52 years. Of these, 46 were female and 66 were male. Among all patients, 87 were admitted to the hospital for observation and surgery, while 25 were discharged after emergency department. Paraduodenal hernias were the most common provisional diagnosis (48 cases). Among these patients, 45 were discharged after symptom relief and were advised for elective re-evaluation. The exact diagnosis for these pa-tients remains unknown. Post-surgery, the diagnosis of internal hernia was confirmed in 32 cases. Among them, 15 were female and 17 were male, with a median age of 52. The median hospital stay for patients diagnosed with internal hernia was 5 days. Although acquired hernias exhibited higher resection and mortality rates, no statistically significant difference was found. Thirty-five cases received dif-ferent diagnoses: 19 had brid ileus, five had volvulus, six had acute appendicitis, one had duodenal perforation, three had gynecological malignancies, and one had renal malignancy.
CONCLUSION
Although internal hernias are rare, early diagnosis and treatment are very important due to the high risk of death. The study findings indicate that increased CT utilization leads to earlier diagnosis and treatment, resulting in improved prognosis for patients. This study holds one of the largest case series in the literature. It provides a novel perspective by evaluating radiologically-diagnosed cases, confirming diagnoses post-surgery, and comparing conditions that mimic internal hernias, thereby making a valuable contribution to the literature.
Topics: Humans; Male; Female; Middle Aged; Retrospective Studies; Hernia, Abdominal; Intestinal Obstruction; Internal Hernia; Abdominal Pain
PubMed: 37791450
DOI: 10.14744/tjtes.2023.36037 -
BMC Geriatrics Oct 2023Constipation is one of the most common non-motor symptoms in PD patients, and the constipation, can appear before motor symptoms. Incorrect treatment of constipation in...
BACKGROUND
Constipation is one of the most common non-motor symptoms in PD patients, and the constipation, can appear before motor symptoms. Incorrect treatment of constipation in PD patients can result in colonic volvulus and pseudo intestinal obstruction, as well as a reduction in the therapeutic effect of anti-PD drugs due to absorption issues. There is, however, no comprehensive and scientific nursing intervention plan for PD patients' constipation who are constipated.
METHODS
A multi-disciplinary nursing research group of five people was established to construct the first draft of intervention plan through literature review. We chose 15 experts from 7 universities and tertiary hospitals spread over 5 provinces (cities), including 4 neurologists, 9 clinical nursing specialists in neurology, 1 dietician, and 1 rehabilitator. Two rounds of consultations were held from April to July 2022 with 15 experts to screen and revise the indicators at each level, confirming their importance and feasibility at each level.
RESULTS
There were three primary indicators (pre-intentional stage, intentional stage, and action stage) in the two rounds of expert correspondence, nine secondary indicators (disease risk perception, adverse consequence expectation, self-efficacy and intention of action; action plan, coping plan and coping self-efficacy; produce healthy behaviors, maintain healthy behaviors, recover behaviors and recover self-efficacy), and 22 tertiary indicators.
CONCLUSIONS
After the implementation of two rounds of Delphi method, the final formed constipation intervention program for PD patients provides the basis for clinical nursing practice, which has the characteristics of convenience, comprehensiveness, dependence, scientific and feasibility. Therefore, it has application and promotion value.
Topics: Humans; Parkinson Disease; Constipation; Adaptation, Psychological; Surveys and Questionnaires; Behavior Therapy
PubMed: 37833627
DOI: 10.1186/s12877-023-04370-7 -
Children (Basel, Switzerland) Aug 2023Sigmoid volvulus (SV) occurs rarely in children. After encountering two cases of recurrent SV, we reviewed the literature to define the recurrence risk, identify outcome... (Review)
Review
Sigmoid volvulus (SV) occurs rarely in children. After encountering two cases of recurrent SV, we reviewed the literature to define the recurrence risk, identify outcome predictors and to give treatment recommendations. We found 256 cases reported in children (mean age 10.2 years, gender ratio (m:f) 2.3:1). Associations exist with Hirschsprung disease (HD) in 10%, neurodevelopmental disorders in 10.9% and chronic constipation in 10.2%. Common symptoms and clinical signs were abdominal pain (85%), distension (85%), tenderness (54%) and vomiting (59%). Signs of peritonitis were present in 14% and indicated a gangrenous sigmoid ( = 45.33; < 0.001). A total of 183 had abdominal radiographs, and 65% showed a positive 'coffee-bean-sign'. Contrast enemas were positive in 90%. A total of 124 patients underwent laparotomy; in 41 cases, the sigmoid was gangrenous and associated with more complications ( = 15.68; < 0.001). Non-operative treatment (NOT) like endoscopic, fluoroscopic or rectal tube decompression was performed in 135 patients and successful in 79% with a 38-57% recurrence rate. A total of 73 patients subjected to elective surgery: 50 underwent sigmoid resection; 17 had surgery for HD. Clinicians should consider SV in all children with abdominal pain, distension and vomiting. Gangrene carries a higher morbidity. After successful NOT we recommend counselling about the recurrence risk and definitive surgery should be advised. HD is frequent in newborns but sometimes found in older children.
PubMed: 37761402
DOI: 10.3390/children10091441