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The Surgical Clinics of North America Oct 2018Intestinal volvulus, regardless of location, is a rare disease process, but one that requires high suspicion and timely diagnosis given the increased incidence of... (Review)
Review
Intestinal volvulus, regardless of location, is a rare disease process, but one that requires high suspicion and timely diagnosis given the increased incidence of intestinal necrosis and potential mortality. Most patients with intestinal volvulus require some form of surgical intervention. However, over the last few decades, the work-up and management of intestinal volvulus has changed given constant advancements in technology and patient care. Most importantly, however, is recognizing the need for emergent versus more elective surgery because this influences the morbidity and mortality for the individual patient.
Topics: Humans; Intestinal Volvulus
PubMed: 30243456
DOI: 10.1016/j.suc.2018.06.005 -
British Journal of Hospital Medicine... Mar 2024Volvulus describes the twisting of the intestine or colon around its mesentery. Intestinal obstruction and/or ischaemia are the most common complications of volvulus.... (Review)
Review
Volvulus describes the twisting of the intestine or colon around its mesentery. Intestinal obstruction and/or ischaemia are the most common complications of volvulus. Within the gastrointestinal tract, there is a preponderance towards colonic volvulus. The sigmoid is the most commonly affected segment, followed by the caecum, small intestine and stomach. Distinguishing between the differing anatomical locations of gastrointestinal volvulus can be challenging, but is important for the management and prognosis. This article focuses on the main anatomical sites of gastrointestinal volvulus encountered in clinical practice. The aetiology, presentation, radiological features and management options for each are discussed to highlight the key differences.
Topics: Humans; Intestinal Volvulus; Intestinal Obstruction; Colon, Sigmoid; Intestine, Small; Radiography
PubMed: 38557088
DOI: 10.12968/hmed.2023.0295 -
Surgery Jul 2022
Topics: Abdomen; Gallbladder; Gallbladder Diseases; Humans; Intestinal Volvulus; Torsion Abnormality
PubMed: 34996603
DOI: 10.1016/j.surg.2021.12.006 -
The New England Journal of Medicine Aug 2022
Topics: Abdomen; Gallbladder Diseases; Humans; Intestinal Volvulus
PubMed: 36070712
DOI: 10.1056/NEJMicm2118625 -
JAMA Jun 2019
Topics: Colonoscopy; Humans; Intestinal Volvulus; Sigmoid Diseases
PubMed: 31237646
DOI: 10.1001/jama.2019.2349 -
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 -
Radiologia 2015Radiologists must be able to recognize the imaging signs of intestinal malrotation because this condition can lead to potentially lethal complications such as midgut... (Review)
Review
Radiologists must be able to recognize the imaging signs of intestinal malrotation because this condition can lead to potentially lethal complications such as midgut volvulus. The correct diagnosis depends on both high clinical suspicion and the radiologist's ability to recognize the specific signs of malrotation and the normal variants that can lead to the wrong diagnosis. Although the location of the third portion of the duodenum outside the retroperitoneal area on ultrasonography, CT, or MRI seems to be a reliable sign of malrotation, the gold standard for determining whether the duodenojejunal flexure is in an abnormal location continues to be the upper gastrointestinal series. In this article, we review the most important imaging signs of malrotation and emphasize the role of ultrasonography in diagnosing midgut volvulus.
Topics: Humans; Intestinal Volvulus; Magnetic Resonance Imaging; Radiology; Tomography, X-Ray Computed; Ultrasonography
PubMed: 25458122
DOI: 10.1016/j.rx.2014.07.007 -
Journal of Visceral Surgery Jun 2016Colonic volvulus is the third leading cause of colonic obstruction worldwide, occurring at two principal locations: the sigmoid colon and cecum. In Western countries,... (Review)
Review
Colonic volvulus is the third leading cause of colonic obstruction worldwide, occurring at two principal locations: the sigmoid colon and cecum. In Western countries, sigmoid volvulus preferentially affects elderly men whereas cecal volvulus affects younger women. Some risk factors, such as chronic constipation, high-fiber diet, frequent use of laxatives, personal past history of laparotomy and anatomic predispositions, are common to both locations. Clinical symptomatology is non-specific, including a combination of abdominal pain, gaseous distention, and bowel obstruction. Abdominopelvic computerized tomography is currently the gold standard examination, allowing positive diagnosis as well as detection of complications. Specific management depends on the location, patient comorbidities and colonic wall viability, but treatment is an emergency in every case. If clinical or radiological signs of gravity are present, emergency surgery is mandatory, but is associated with high morbidity and mortality rates. For sigmoid volvulus without criteria of gravity, the ideal strategy is an endoscopic detorsion procedure followed, within 2 to 5 days, by surgery that includes a sigmoid colectomy with primary anastomosis. Exclusively endoscopic therapy must be reserved for patients who are at excessive risk for surgical intervention. In cecal volvulus, endoscopy has no role and surgery is the rule.
Topics: Colectomy; Colonic Diseases; Colonoscopy; Humans; Intestinal Obstruction; Intestinal Volvulus; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27132752
DOI: 10.1016/j.jviscsurg.2016.03.006 -
The Surgical Clinics of North America Feb 2017Rotation abnormalities may be asymptomatic or may be associated with obstruction caused by bands, midgut volvulus, or associated atresia or web. The most important goal... (Review)
Review
Rotation abnormalities may be asymptomatic or may be associated with obstruction caused by bands, midgut volvulus, or associated atresia or web. The most important goal of clinicians is to determine whether the patient has midgut volvulus with intestinal ischemia, in which case an emergency laparotomy should be done. If the patient is not acutely ill, the next goal is to determine whether the patient has a narrow-based small bowel mesentery. In general, the outcomes for children with a rotation abnormality are excellent, unless there has been midgut volvulus with significant intestinal ischemia.
Topics: Child; Diagnostic Imaging; Digestive System Abnormalities; Humans; Intestinal Obstruction; Intestinal Volvulus; Laparotomy
PubMed: 27894424
DOI: 10.1016/j.suc.2016.08.011 -
The Journal of Pediatrics Apr 2020
Topics: Female; Humans; Infant, Newborn; Intestinal Volvulus; Radiography
PubMed: 31870608
DOI: 10.1016/j.jpeds.2019.11.017