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Medicine Dec 2017Sigmoid volvulus (SV) is an exceptionally rare but potentially life-threatening condition in children. (Review)
Review
RATIONALE
Sigmoid volvulus (SV) is an exceptionally rare but potentially life-threatening condition in children.
CHIEF COMPLAINT
Abdominal distention for 1 week.
DIAGNOSES
Sigmoid volvulus.
PATIENT CONCERNS
We present a case of a 12-year-old boy with mechanical ileus who was finally confirmed to have SV with the combination of abdominal plain film, sonography, and computed tomography (CT) with the finding of mesenteric artery rotation.
INTERVENTIONS
Because bowel obstruction was suspected, abdominal plain film, sonography, and CT were performed. The abdominal CT demonstrated whirlpool sign with torsion of the sigmoid vessels. In addition, lower gastrointestinal filling study showed that the contrast medium could only reach the upper descending colon. Therefore, he received laparotomy with mesosigmoidoplasty for detorsion of the sigmoid.
OUTCOMES
The postoperative recovery was smooth under empirical antibiotic treatment with cefazolin. A follow-up lower gastrointestinal series on the seventh day of admission showed no obstruction compared with the previous series. He was finally discharged in a stable condition 8 days after admission.
LESSONS
SV is a congenital anomaly and an uncommon diagnosis in children. Nevertheless, case series and case reports of SV are becoming more prevalent in the literature. Failure to recognize SV may result in life-threatening complications such as sigmoid gangrene/perforation, peritonitis, sepsis, and death. Thus, if the children have persistent and recurrent abdominal distention, abdominal pain, and vomiting, physicians should consider SV as a "do not miss diagnosis" in the differential diagnosis.
Topics: Child; Humans; Intestinal Volvulus; Male; Sigmoid Diseases; Tomography, X-Ray Computed
PubMed: 29384922
DOI: 10.1097/MD.0000000000009434 -
Journal of Visceral Surgery Jun 2024Common mesentery is an abnormal rotation of the primary umbilical loop characterized by inverted positioning of the mesenteric vessels; the mesenteric vein is displaced...
Common mesentery is an abnormal rotation of the primary umbilical loop characterized by inverted positioning of the mesenteric vessels; the mesenteric vein is displaced to the left of the artery. The inversion can be complete or incomplete. If it is incomplete, the mesenteric root is very short, with an empty right iliac fossa and the caecum in high median or subhepatic position. If it is complete, the entire small intestine is on the right, the entire large intestine is on the left; there is no third duodenum, and the second duodenum is anastomosed in the jejunum to the right of the superior mesenteric vessels. Cecal volvulus is a rarely encountered cause of acute intestinal occlusion and should be considered as a surgical emergency. There exist two main types of volvulus: by twisting of the large intestine around its axis, which remains in place; or by tilt and to rotation of the colon, which changes position.
Topics: Intestinal Volvulus; Humans; Cecal Diseases; Mesentery; Male; Female; Tomography, X-Ray Computed
PubMed: 38453591
DOI: 10.1016/j.jviscsurg.2024.02.006 -
British Journal of Hospital Medicine... Jul 2008
Topics: Humans; Intestinal Volvulus; Laparotomy; Male; Middle Aged; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 18833979
DOI: 10.12968/hmed.2008.69.7.30420 -
American Journal of Surgery Apr 2008Case presentation and literature review for intestinal malrotation presenting in an adult. Although the number of patients with this condition that escape infancy... (Review)
Review
Case presentation and literature review for intestinal malrotation presenting in an adult. Although the number of patients with this condition that escape infancy undiagnosed is not clear, it is clear that when the rare patient presents as an adult it can be a perplexing situation for surgeons not familiar with the presenting signs and anatomy. This confusion can lead to diagnostic and intraoperative errors.
Topics: Abdominal Pain; Adult; Diagnosis, Differential; Diagnostic Errors; Duodenum; Female; Gastrointestinal Tract; Humans; Intestinal Volvulus; Jejunum; Tomography, X-Ray Computed; Torsion Abnormality; Weight Loss
PubMed: 18304508
DOI: 10.1016/j.amjsurg.2006.09.036 -
Balkan Medical Journal Jan 2021Hirschsprung's disease and sigmoid volvulus can sometimes be seen in the same patient.
BACKGROUND
Hirschsprung's disease and sigmoid volvulus can sometimes be seen in the same patient.
AIMS
To investigate the presence of Hirschsprung's disease in patients with sigmoid volvulus and to discuss the diagnosis and treatment methods.
STUDY DESIGN
Systematic review.
METHODS
This systematic review has been reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the methodological quality of systematic reviews guidelines. The PubMed and Scopus databases were scanned using the keywords "Hirschsprung* volvulus*" and "congenital aganglionic megacolon volvulus*". The reference list of the selected studies was reviewed for cross-checking. Two reviewers independently screened the available literature. Only the Hirschsprung's disease cases involving sigmoid volvulus were included, and cases of patients with volvulus in other sites was excluded. There was no restriction with respect to the publication language and type of writing. The primary outcome was morbidity and mortality.
RESULTS
A total of 31 cases were analyzed in 22 articles; 97% of the patients were under the age of 40, 90% were male. There was a statistically significant difference in the necessity for relaparotomy between patients who were scheduled for sigmoid volvulus therapy with the suspicion of Hirschsprung's disease and patients who were treated without suspicion of Hirschsprung's disease (0% vs 37.5%, p=0.02). While there was no postoperative death in cases with suspected Hirschsprung disease, this mortality rate was 25% in cases without suspicion (p = 0.08).
CONCLUSION
Hirschsprung's disease should be excluded with rectal biopsy if a patient with sigmoid volvulus is under 40 years of age and has complaints of constipation from childhood.
Topics: Adult; Aged, 80 and over; Child; Child, Preschool; Female; Hirschsprung Disease; Humans; Infant; Infant, Newborn; Intestinal Volvulus; Male
PubMed: 32856883
DOI: 10.4274/balkanmedj.galenos.2020.2020.4.131 -
La Pediatria Medica E Chirurgica :... 2005Midgut malrotation with volvulus is a life-threatening surgical emergency. Because the consequences of malrotation associated with midgut volvulus may be catastrophic,... (Review)
Review
Midgut malrotation with volvulus is a life-threatening surgical emergency. Because the consequences of malrotation associated with midgut volvulus may be catastrophic, prompt diagnosis and treatment are required to prevent mortality and short-gut syndrome. Intestinal malrotation is usually observed in the neonatal period. Bilious vomiting and bloody stools are the two most common clinical presentations, but the patients exhibit often no abnormal physical findings on abdominal examination. Imaging techniques (Rx, US) of the upper gastrointestinal tract must be very accurate in order to diagnose volvulus but frequently they fail to identify this illness. If any doubt exists, refer with pediatric surgical support for consultation.
Topics: Humans; Infant, Newborn; Intestinal Volvulus; Intestines; Prognosis
PubMed: 16922046
DOI: No ID Found -
Clinical Autonomic Research : Official... Jun 2020
Topics: Humans; Intestinal Volvulus; Parkinson Disease
PubMed: 31838591
DOI: 10.1007/s10286-019-00658-0 -
Cirugia Y Cirujanos 2021A 102-year-old female with a past medical history of sigmoid volvulus resolved by colonoscopy a year ago presents to the emergency department with sigmoid volvulus,...
A 102-year-old female with a past medical history of sigmoid volvulus resolved by colonoscopy a year ago presents to the emergency department with sigmoid volvulus, which is resolved by colonoscopy and rectal tube placement. Three days later, she presented abdominal distention and recurrence of the volvulus, for which a surgical resolution was decided. Laparotomy was performed, where sigmoid and cecal volvulus was found. A cecal detorsion and a cecopexy were performed, and an extended left hemicolectomy with a terminal colostomy to treat the sigmoid volvulus. The patient presents an adequate postoperative period and is discharged. Three months later, the patient was in good clinical condition, eating normally without complications. Volvulus refers to the torsion of a segment of the gastrointestinal tract. The most common sites for colonic volvulus are sigmoid and cecum; however, it is infrequent for these to occur together. We only found six cases reported in the literature of synchronous volvulus of the cecum and sigmoid colon. None of the cases was the diagnosis made preoperatively, suggesting a difficult diagnosis. Treatment depends on the patient's condition; in most reported cases, a subtotal colectomy was performed. The prognosis depends on prompt surgical intervention.
Topics: Aged, 80 and over; Cecum; Colectomy; Colon, Sigmoid; Female; Humans; Intestinal Obstruction; Intestinal Volvulus
PubMed: 34932538
DOI: 10.24875/CIRU.21000044 -
Revista Espanola de Enfermedades... Oct 2020Jejunal volvules are a very rare condition, barely reported in the literature, that occur in relation to congenital (eg, intestinal duplication) or acquired disorders...
Jejunal volvules are a very rare condition, barely reported in the literature, that occur in relation to congenital (eg, intestinal duplication) or acquired disorders (eg, diaphragmatic hernias or tumors). In the event that it becomes complicated with an established intestinal ischemia, its prognosis is further overshadowed by the possible consequences of a complex surgery, given the high risk of short bowel syndrome. Being a PEG probe carrier does not seem to be related to the picture.
Topics: Hernias, Diaphragmatic, Congenital; Humans; Intestinal Volvulus; Intestines; Ischemia; Jejunum
PubMed: 32954787
DOI: 10.17235/reed.2020.6769/2019 -
Malawi Medical Journal : the Journal of... Jun 2022Acute intestinal obstruction is rare during pregnancy. Its diagnosis is difficult because the symptoms can be minimal and mimic signs of a regular pregnancy. Sigmoid...
Acute intestinal obstruction is rare during pregnancy. Its diagnosis is difficult because the symptoms can be minimal and mimic signs of a regular pregnancy. Sigmoid volvulus is a common cause of these obstructions. The management is challenging because it depends on many factors, and affects maternal-fetal outcomes. We report a case of a 32-year-old woman with sigmoid volvulus associated with fetal demise that came during labor and we discuss the management options.
Topics: Acute Disease; Adult; Female; Humans; Intestinal Obstruction; Intestinal Volvulus; Pregnancy; Sigmoid Diseases
PubMed: 35991812
DOI: 10.4314/mmj.v34i2.12