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BMJ Case Reports Mar 2022Caecal herniation through the foramen of Winslow is an uncommon presentation of internal hernia with an estimated overall incidence of 0.02%. Even rarer still is a...
Caecal herniation through the foramen of Winslow is an uncommon presentation of internal hernia with an estimated overall incidence of 0.02%. Even rarer still is a caecal volvulus strangulated in the lesser sac, a surgical emergency seldom described in the literature. A woman in her 70s presented with a 1-day history of acute-onset right upper quadrant and epigastric pain associated with nausea and vomiting. Prompt CT imaging revealed caecal volvulus within a foramen of Winslow hernia. The diagnosis was confirmed by laparotomy. A right hemicolectomy was performed and the foraminal defect was closed. We identified eight case reports of this rare entity published within the last 30 years. Our patient was managed in a similar manner and recovered without complication, providing further guidance for the operative management of caecal volvulus in the foramen of Winslow.
Topics: Cecum; Colectomy; Female; Hernia; Hernia, Abdominal; Humans; Internal Hernia; Intestinal Volvulus
PubMed: 35236689
DOI: 10.1136/bcr-2021-247316 -
Endoscopy Dec 2022
Topics: Humans; Child; Intestinal Volvulus; Sigmoid Diseases; Colon, Sigmoid; Intestinal Obstruction
PubMed: 35750084
DOI: 10.1055/a-1858-4826 -
PloS One 2018This study evaluated the association between a selection of candidate predictor variables, including the elevation of specific pancreatic enzymes, and outcome in dogs...
This study evaluated the association between a selection of candidate predictor variables, including the elevation of specific pancreatic enzymes, and outcome in dogs with gastric dilatation-volvulus (GDV). Twenty-two dogs with gastric dilatation-volvulus were included, being classified as survivors or non-survivors based on the final outcome. Dogs with intestinal obstruction (n = 16) were selected for comparison. Blood samples were collected upon admission (T0) and after 24 hours (T1). Serum lipase activity, canine pancreatic lipase immunoreactivity (cPLI) and other variables (plasma lactate concentration and C- reactive protein -CRP- in particular) were evaluated as predictive variables. T0 cPLI and serum lipase activity were not found to differ significantly between dogs with gastric dilatation-volvulus or intestinal obstruction. Canine pancreatic lipase immunoreactivity values above 400 μg/L were detected in 6/22 dogs with gastric dilatation-volvulus and 4/16 with intestinal obstruction. However, lactate concentration was significantly higher and CRP significantly lower in GDV as compared to IO dogs, and in the GDV group, lipase, cPLI and CRP measured upon admission were significantly associated with a negative outcome. No differences in lipase activity and canine pancreatic lipase immunoreactivity values were detected between T0 and T1. Presurgical cPLI and lipase activity were frequently increased during gastric dilatation-volvulus and were suggestive of the presence of pancreatic damage; while more extensive studies are required, based on this pilot analysis, cPLI has the potential to be a useful predictive variable for outcome in GDV. Further to this, serum CRP was able to predict outcome in this population of dogs with GDV, while blood lactate was not.
Topics: Animals; C-Reactive Protein; Dog Diseases; Dogs; Female; Gastric Dilatation; Hospitalization; Intestinal Obstruction; Intestinal Volvulus; Lactic Acid; Lipase; Male; Pancreas; Prognosis; Prospective Studies; ROC Curve
PubMed: 30226861
DOI: 10.1371/journal.pone.0204216 -
British Medical Journal Jul 1952
Topics: Digestive System Abnormalities; Hallux; Hallux Valgus; Humans; Intestinal Volvulus
PubMed: 14935373
DOI: No ID Found -
Revista Espanola de Enfermedades... Apr 2010the diagnostic and therapeutic management of colonic volvulus remains nowadays controversial. The election of the type of surgery, its timing, or the use of...
BACKGROUND
the diagnostic and therapeutic management of colonic volvulus remains nowadays controversial. The election of the type of surgery, its timing, or the use of non-operative decompression must be based on the experience of a multidisciplinary team, the clinical condition of the patient, and the type of volvulus.
OBJECTIVES
the purpose of this study is to review our experience and results in the treatment of patients with colonic volvulus.
MATERIAL AND METHODS
we performed a retrospective study of patients diagnosed of colonic volvulus between January 1990 and September 2008 in our institution.
RESULTS
we included a total of 75 patients with a mean age of 72.7 years and, in most cases, with associated comorbidities and constipation. The most frequently involved segment was sigmoid colon (85.3%). A rectal tube insertion was used as the only therapeutic measure in 17 patients (22.4%), colonoscopic decompression in 17 (22.4%), and surgery in 41 patients (55.2%). Intestinal resection with primary anastomosis was the most common surgical option. Postoperative morbidity was 43%, being wound infections the most frequent complication. In the group of non-surgical treatment morbidity was 26.4%, albeit with a higher and early rate of recurrences.
CONCLUSIONS
treatment of colonic volvulus present important morbidity and mortality rates, and its treatment must be individualized. Resective surgery with primary anastomosis in clinically stable patients is the most appropriate therapeutic option, offering the lower recurrence rates.
Topics: Aged; Colon, Sigmoid; Colonic Diseases; Digestive System Surgical Procedures; Endoscopy; Female; Humans; Intestinal Volvulus; Male; Postoperative Complications; Retrospective Studies
PubMed: 20486746
DOI: 10.4321/s1130-01082010000400004 -
Postgraduate Medical Journal Dec 2005Caecal volvulus is an infrequently encountered clinical condition and an uncommon cause of intestinal obstruction. Patients with this condition may present with highly... (Review)
Review
Caecal volvulus is an infrequently encountered clinical condition and an uncommon cause of intestinal obstruction. Patients with this condition may present with highly variable clinical presentations ranging from intermittent, self limiting abdominal pain to acute abdominal pain associated with intestinal strangulation and sepsis. Lack of familiarity with this condition is a factor contributing to diagnostic and treatment delays. The objective of this review is to promote clinicians' awareness of this disease through patient case illustration, discussion of disease pathogenesis, clinical features, and management strategies.
Topics: Acute Disease; Cecal Diseases; Diagnostic Imaging; Early Diagnosis; Humans; Intestinal Volvulus; Prognosis; Recurrence
PubMed: 16344301
DOI: 10.1136/pgmj.2005.035311 -
The Turkish Journal of Gastroenterology... Mar 2018Cases of colonic volvulus in children are infrequently described in the literature. Here we describe the case of three patients with colonic volvulus. The first patient...
Cases of colonic volvulus in children are infrequently described in the literature. Here we describe the case of three patients with colonic volvulus. The first patient was a 10-year-old girl with abdominal dilation and pain and no bowel movement for 48 h. Her abdominal X-ray showed the coffee bean sign adjacent to the diaphragm, which was compatible with a diagnosis of cecal volvulus. The second patient was a 4-year-old boy with a history of chronic constipation during the past year and with no bowel movement for 24 h. Clinical manifestations included severe nausea, vomiting, and abdominal distension. His abdominal X-ray demonstrated the coffee bean sign in the right upper quadrant with upward convexity corresponding to a diagnosis of sigmoid volvulus. The third patient was a 10-month-old male who presented with excessive crying, malnutrition, and no bowel movement for 36 h. His abdominal X-ray demonstrated the coffee bean sign in the left upper quadrant with upward convexity. The presence of gas was not observed in the distal obstructed region, corresponding to a diagnosis of sigmoid volvulus. All three patients successfully underwent colonoscopy for volvulus reduction. Volvulus did not reoccur in any of the patients within 6 months of follow-up. It is recommended to perform abdominal X-ray imaging in patients who present with abdominal pain and distension, diarrhea, or constipation for possibly diagnosing volvulus.
Topics: Cecal Diseases; Child; Child, Preschool; Colonoscopy; Decompression, Surgical; Female; Humans; Infant; Intestinal Volvulus; Male; Sigmoid Diseases; Treatment Outcome
PubMed: 29749331
DOI: 10.5152/tjg.2018.17507 -
Experimental and Clinical... Feb 2022Pancreas transplant is one of the known most effective treatments for type 1 diabetes mellitus and is associated with improved survival and quality of life for patients....
Pancreas transplant is one of the known most effective treatments for type 1 diabetes mellitus and is associated with improved survival and quality of life for patients. Most centers use a direct side-to-side anastomosis between the donor's duodenum and jejunum, and we describe a rare complication that affected 2 patients. The 2 patients each received a simultaneous kidney-pancreas transplant and presented with side-to-side duodenojejunal anastomosis volvulus. We describe the clinical and radiological presentations and then propose an effective management method. Side-to-side duodenojejunal anastomosis volvulus after pancreas transplant is an exceptional complication, and there are special radiological and surgical manage-ment techniques to allow efficient treatment.
Topics: Humans; Intestinal Volvulus; Quality of Life; Duodenum; Pancreas Transplantation; Diabetes Mellitus, Type 1; Anastomosis, Surgical; Pancreas
PubMed: 36656121
DOI: 10.6002/ect.2022.0230 -
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 -
PloS One 2021Sigmoid colon anatomic dimensions have been studied to have roles in the occurrence of sigmoid volvulus; however, these studies are few in number and failed to control...
INTRODUCTION
Sigmoid colon anatomic dimensions have been studied to have roles in the occurrence of sigmoid volvulus; however, these studies are few in number and failed to control the confounding effect of acute sigmoid obstruction on the anatomic dimensions. The main objective of this study was to assess the role of sigmoid colon anatomic dimensions in the development of sigmoid volvulus controlling the effect of acute sigmoid obstruction on the anatomic dimensions.
MATERIALS AND METHODS
The study was carried out from Dec, 2019 to April, 2021 at Tibebe Ghion Specialized Hospital and Felege Hiwot Comprehensive Specialized Hospital, two referral hospitals in Bahir Dar city, North-Western Ethiopia to compare sigmoid anatomic dimensions among three independent groups of participants: patients with no history of sigmoid volvulus (I), those for whom elective surgery was done after non-surgical detorsion of sigmoid volvulus (II), and patients for whom emergency surgery was done for sigmoid volvulus (III). The anatomic dimensions were compared using fixed effects one-way ANOVA or Kruskal-Wallis H test at p-value ≤ .05 (two-sided) and Tukey method or Dunn-Bonferroni's test was used for post-hoc comparisons.
RESULTS
A total of 66 consecutive eligible patients (22 for each of the three groups) were included and analyzed in the study. The means of anatomic dimensions (in cm) for groups (I, II, III) were: sigmoid colon length-SCL (35.91, 71.07, 80.86), meso-sigmoid height-MSH (17.11, 26.52, 28.86), meso-sigmoid maximal width-MSMW (9.70, 14.89,16.80), and meso-sigmoid root width-MSRW (8.34, 7.48, 8.11). SCL, MSH, MSMW, MSH/MSRW, and MSMW/MSRW were found to be statistically significantly different in patients with sigmoid volvulus. MSRW and MSH/MSMW were not different between the study groups.
CONCLUSION
A long sigmoid colon with long and wide mesentery, but with a constant base is highly likely to predispose individuals to sigmoid volvulus.
Topics: Adult; Aged; Body Height; Body Weight; Colon, Sigmoid; Elective Surgical Procedures; Ethiopia; Female; Hospitalization; Humans; Intestinal Volvulus; Male; Middle Aged; Sigmoid Diseases
PubMed: 34851992
DOI: 10.1371/journal.pone.0260708