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Clinical Gastroenterology and... Aug 2020
Topics: Humans; Intestinal Volvulus; Intestine, Small; Lymphangioma; Mesentery
PubMed: 31077830
DOI: 10.1016/j.cgh.2019.04.074 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Mar 2022Sigmoid volvulus (SV), the wrapping of the sigmoid colon around itself, is a rare intestinal obstruction form world-wide. For this reason, the physiopathology of SV,...
BACKGROUND
Sigmoid volvulus (SV), the wrapping of the sigmoid colon around itself, is a rare intestinal obstruction form world-wide. For this reason, the physiopathology of SV, particularly the precipitating factors, are not clearly identified. The aim of this study is to evaluate the precipitating factors in SV.
METHODS
The clinical records of consecutive 416 patients with SV were reviewed prospectively from January 1986 to July 2020. As a control, the records of consecutive 100 patients with non-volvulus intestinal obstruction were reviewed prospectively in the past 24 months. The premorbid symptoms including acute diarrhea, sudden and excessive body motions, overeating after a prolonged starvation, coughing spell, and labor was evaluated.
RESULTS
Among the premorbid symptoms, 1-5-day interval of diarrhea (42 patients, 10.1%, p<0.05), harvesting activation (35 patients, 8.4%, p<0.05), and overeating after Ramadan fasting (31 patients, 7.5%, p<0.05) were found to be statistically significant precipitating factors in SV.
CONCLUSION
Although there are few studies about the precipitating factors of SV in the literature, increased bowel motility, excessive body motions, and overeating following a prolonged starvation look like the precipitating factors in the development of SV.
Topics: Diarrhea; Humans; Hyperphagia; Intestinal Obstruction; Intestinal Volvulus; Sigmoid Diseases
PubMed: 35485550
DOI: 10.14744/tjtes.2020.03762 -
Internal Medicine (Tokyo, Japan) 2011
Topics: Aged; Aged, 80 and over; Cecal Diseases; Colonoscopy; Female; Humans; Intestinal Volvulus; Tomography, X-Ray Computed
PubMed: 21212577
DOI: 10.2169/internalmedicine.50.4073 -
World Journal of Surgery Jul 2020Intestinal volvulus is a common cause of mechanical intestinal obstruction (MIO) in Africa. Sigmoid volvulus has been well characterized in both high-income and...
BACKGROUND
Intestinal volvulus is a common cause of mechanical intestinal obstruction (MIO) in Africa. Sigmoid volvulus has been well characterized in both high-income and low-income countries, but there is also a predilection for small bowel volvulus in sub-Saharan Africa.
METHODS
An analysis was performed of the Kamuzu Central Hospital Acute Care Surgery Registry from 2013 to 2019 on patients presenting with intestinal volvulus. Bivariate analysis was performed for covariates based on the intestinal volvulus type. Multivariate Poisson regression models estimated the relative risk of volvulus and mortality.
RESULTS
A total of 4352 patients were captured in the registry. Overall, 1037 patients (23.8%) were diagnosed with MIO. Intestinal volvulus accounted for 499 (48.1%) of patients with MIO. Sigmoid volvulus, midgut volvulus, ileosigmoid knotting, and cecal volvulus accounted for 57.7% (n = 288), 19.8% (n = 99), 20.8% (n = 104), and 1.6% (n = 8), respectively. Mean age was 46.8 years (SD 17.2) with a male preponderance (n = 429, 86.0%) and 14.8% (n = 74) mortality. Overall, the most common operations performed were large bowel (n = 326, 74.4%) and small bowel (n = 76, 16.7%) resections with 18.0% (n = 90) ostomy formation. Upon regression modeling, the relative risk for volvulus was 2.7 times higher in men than women after controlling for season and age. There was no statistically significant difference in the relative risk of mortality based on the type of volvulus.
CONCLUSION
Volvulus is a significant cause of primary bowel obstruction in sub-Saharan Africa. Type of intestinal volvulus is not associated increased risk of mortality. Reasons for increases in the incidence of small bowel volvulus are still largely undetermined.
Topics: Adult; Female; Humans; Incidence; Intestinal Obstruction; Intestinal Volvulus; Male; Middle Aged; Retrospective Studies
PubMed: 32100066
DOI: 10.1007/s00268-020-05440-2 -
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 -
Seminars in Pediatric Surgery Nov 2003The subject of malrotation and midgut volvulus in infancy and childhood is reviewed from the perspective of experience with 138 patients evaluated in a published series... (Review)
Review
The subject of malrotation and midgut volvulus in infancy and childhood is reviewed from the perspective of experience with 138 patients evaluated in a published series and a further 82 cases seen since. Embryology, historical aspects, clinical presentation, investigation, surgery, and outcome are discussed. The diagnosis of malrotation and volvulus should always be kept in mind when assessing any infant or child with symptoms of vomiting and pain, particularly when the vomiting is bile-stained. The diagnosis cannot be excluded if diarrhea is present, when clinical findings are bland, or even with normal abdominal radiographs. A contrast meal and follow-through should be done and, if correctly interpreted, should be diagnostic. Ultrasound examination may be helpful but is not secure enough to exclude the diagnosis. Laparotomy or laparoscopy is the only way to be sure. Malrotation with its propensity for volvulus is truly a time bomb lying within.
Topics: Abdominal Pain; Bile; Child; Female; Humans; Infant; Infant, Newborn; Intestinal Volvulus; Intestines; Male; Vomiting
PubMed: 14655161
DOI: 10.1053/j.sempedsurg.2003.08.003 -
Revista de Gastroenterologia de Mexico... 2021
Topics: Appendectomy; Humans; Intestinal Obstruction; Intestinal Volvulus; Intestine, Small; Laparoscopy
PubMed: 34391703
DOI: 10.1016/j.rgmxen.2021.08.004 -
BMJ Case Reports Aug 2023A caecal volvulus is a rare, but severe complication to a caesarean section, with serious risks of perforation, necrosis and peritonitis. We describe a case of a Middle...
A caecal volvulus is a rare, but severe complication to a caesarean section, with serious risks of perforation, necrosis and peritonitis. We describe a case of a Middle Eastern woman admitted for an elective caesarean section due to a history of three cesareans in her home country. The operation was complicated by massive adhesions and a postpartum bleed of 1750 mL. She developed severe abdominal pain refractory to strong pain medication postoperatively. She was diagnosed with a caecal volvulus without perforation on CT, which was confirmed by laparotomy. The patient was treated with a hemicolectomy and made a full recovery.
Topics: Female; Pregnancy; Humans; Cesarean Section; Intestinal Volvulus; Abdominal Pain; Colectomy; Hospitalization
PubMed: 37607760
DOI: 10.1136/bcr-2022-252757 -
The Journal of Pediatrics Jun 2022
Topics: Adolescent; Cecal Diseases; Humans; Intestinal Obstruction; Intestinal Volvulus
PubMed: 35301020
DOI: 10.1016/j.jpeds.2022.03.010 -
American Journal of Surgery Jan 2023There is limited epidemiologic data on sigmoid volvulus (SV) from non-endemic regions. Therefore, we performed a multicenter study to report contemporary outcomes and...
BACKGROUND
There is limited epidemiologic data on sigmoid volvulus (SV) from non-endemic regions. Therefore, we performed a multicenter study to report contemporary outcomes and appraise literature-based methods that pair diagnostic and procedural codes to identify SV.
METHOD
Using an automated search for patients with 'volvulus' in our system from 2011 to 2021, we reviewed electronic charts to clarify the diagnosis, automatically replicate three strategies to identify SV, and retrieved 6-month outcomes.
RESULTS
Of 895 patients, 109 had SV. Literature-based strategies poorly identified SV. At the index admission, patients underwent endoscopic reduction alone (33%), emergent (16.5%), semi-elective (34%), or elective (16.5%) surgery. Endoscopic reduction alone had high recurrence rates and delayed surgery was associated with worse outcomes.
CONCLUSION
Literature-based strategies to identify SV suffer from misclassification bias which affects patient counseling. In this large series, one-third of patients do not undergo during their index admission despite improved outcomes with earlier surgery.
Topics: Humans; Intestinal Volvulus; Multicenter Studies as Topic; Sigmoid Diseases; Sigmoidoscopy
PubMed: 35934559
DOI: 10.1016/j.amjsurg.2022.07.025