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Radiologia 2015Gastrointestinal volvuli cause processes that manifest as acute abdomen. Volvuli are important not because they are common, but rather because their possible... (Review)
Review
Gastrointestinal volvuli cause processes that manifest as acute abdomen. Volvuli are important not because they are common, but rather because their possible complications can be severe. All types of volvuli share a common pathophysiology, which consists of intestinal obstruction in a closed loop that results in ischemia. The clinical manifestations are nonspecific, so radiologists play a very important role in the early identification of the most common signs of torsion. These include the "bird's beak sign", the "whirlpool sign", and signs of potentially reversible or irreversible ischemia. The treatment of choice in most cases is surgery, either to correct the torsion and save the organ or to resect it if it is necrotic.
Topics: Humans; Intestinal Volvulus; Multidetector Computed Tomography; Radiography; Stomach Volvulus
PubMed: 24703987
DOI: 10.1016/j.rx.2013.09.008 -
CMAJ : Canadian Medical Association... Jun 2008
Topics: Aged, 80 and over; Colonoscopy; Decompression; Diagnosis, Differential; Humans; Intestinal Volvulus; Male; Radiography, Abdominal; Sigmoid Diseases
PubMed: 18559802
DOI: 10.1503/cmaj.071760 -
CMAJ : Canadian Medical Association... May 2013
Topics: Aged; Cecum; Diagnosis, Differential; Female; Humans; Intestinal Volvulus; Radiography
PubMed: 23027907
DOI: 10.1503/cmaj.120651 -
BMC Surgery Oct 2020Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric...
BACKGROUND
Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia.
METHOD
The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4-year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV.
RESULT
There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within 4 years. The annual occurrence rate was 35cases per year. It represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority were males (N = 125, 84.5%) and females were (N = 23, 15.5%). The age ranged from 15 to 78 years. The mean age was 41.14 ± (SD = 15.4). The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR = 2). The mean duration of illness before hospital admission was 2 days (± SD = 1.4) and median was 1 day (± IQR = 2). The morbidity rate was 5.4% (N = 8) and the mortality rate was 3.4%(N = 5).
CONCLUSION
Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.
Topics: Adolescent; Adult; Aged; Cross-Sectional Studies; Ethiopia; Female; Humans; Intestinal Obstruction; Intestinal Volvulus; Male; Middle Aged; Retrospective Studies; Young Adult
PubMed: 33008425
DOI: 10.1186/s12893-020-00886-6 -
Diagnostic and Interventional Imaging Feb 2022
Topics: Colon, Sigmoid; Humans; Intestinal Obstruction; Intestinal Volvulus; Recurrence; Sigmoid Diseases; Tomography, X-Ray Computed
PubMed: 35086787
DOI: 10.1016/j.diii.2022.01.007 -
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 -
Cirugia Y Cirujanos 2015Small bowel volvulus is a rare cause of intestinal obstruction in adult patients. This disease is more common in children and its aetiology and management is different... (Review)
Review
BACKGROUND
Small bowel volvulus is a rare cause of intestinal obstruction in adult patients. This disease is more common in children and its aetiology and management is different to that in adults.
CLINICAL CASE
A 30 year-old male with sarcoidosis presents with acute abdomen and clinical data of intestinal obstruction. Small bowel volvulus is diagnosed by a contrast abdominal tomography and an exploratory laparotomy is performed with devolvulation and no intestinal resection. In the days following surgery, he developed a recurrent small bowel volvulus, which was again managed with surgery, but without intestinal resection. Medical treatment for sarcoidosis was started, and with his clinical progress being satisfactory,he was discharged to home.
CONCLUSIONS
Making an early and correct diagnosis of small bowel volvulus prevents large intestinal resections. Many surgical procedures have been described with a high rate of complications. Therefore, conservative surgical management (no intestinal resection) is recommended as the best treatment with the lowest morbidity and mortality rate.
Topics: Adult; Humans; Ileus; Immunosuppressive Agents; Incidence; Intestinal Obstruction; Intestinal Volvulus; Intestine, Small; Laparotomy; Male; Mesentery; Postoperative Complications; Recurrence; Sarcoidosis; Tomography, Spiral Computed
PubMed: 26144269
DOI: 10.1016/j.circir.2015.05.033 -
The Turkish Journal of Pediatrics 2022To evaluate the predictability of clinical and radiological findings in the diagnosis of malrotation.
BACKGROUND
To evaluate the predictability of clinical and radiological findings in the diagnosis of malrotation.
METHODS
Between 2010 and 2020, children with presumptive diagnosis of malrotation were included. The demographic features, clinical and radiological findings, operative findings and outcome were recorded. The upper gastrointestinal series (UGIS) were evaluated by two radiologists. All parameters were correlated with surgical findings to evaluate the predictability.
RESULTS
Seventy patients were included. The presenting symptom was bilious vomiting in 29 cases (41.4%), and atypical symptoms (non-bilious vomiting, food refusal, etc.) in 40 cases (57%). One of the cases (1.6%) was asymptomatic and diagnosed incidentally during UGIS. 52 cases had abdominal X-ray and 14 (26.9%) of them were normal. Doppler ultrasonography (US) (n=20) revealed evidence of malrotation in 13 cases (65%). The location of duodenojejunal junction (DJJ) in UGIS was compatible with malrotation in 33 cases. 48 (61%) cases underwent surgical exploration; 35 cases had malrotation and seven cases had midgut volvulus. Median followup time was one year (0.5-7 years). Volvulus has recurred in one case and another case operated for volvulus died because of short bowel syndrome. The statistical analysis for predictability revealed that bilious vomiting (sensitivity: 57.1%, specificity: 82.1%), Doppler US (sensitivity: 92.3%, specificity: 75%) and right-sided DJJ in UGIS (sensitivity: 96.8%, specificity: 75%) have highest predictability.
CONCLUSIONS
The bilious vomiting, Doppler US findings and right-sided DJJ have the highest predictability to confirm the diagnosis. However, presenting with atypical symptoms and having atypical or normal findings in UGIS do not rule out malrotation.
Topics: Child; Humans; Intestinal Volvulus; Radiography, Abdominal; Ultrasonography; Vomiting
PubMed: 36082638
DOI: 10.24953/turkjped.2021.5019 -
Veterinary Surgery : VS Apr 2020To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and...
OBJECTIVE
To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy.
STUDY DESIGN
Prospective clinical study.
ANIMALS
Forty adult horses in which large colon volvulus was diagnosed intraoperatively.
METHODS
Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant.
RESULTS
No association was found between colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large colon volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome.
CONCLUSION
Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners.
CLINICAL SIGNIFICANCE
Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.
Topics: Animals; Biopsy; Blood Gas Analysis; Colon; Female; Hemorrhage; Horse Diseases; Horses; Intestinal Volvulus; Lactates; Male; Prognosis; Prospective Studies
PubMed: 31916608
DOI: 10.1111/vsu.13361 -
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