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The Canadian Veterinary Journal = La... Jun 2019A 5-month-old Bernese mountain dog was presented for unproductive vomitus and abdominal distension. A gastric dilatation and volvulus was diagnosed. The dog underwent...
A 5-month-old Bernese mountain dog was presented for unproductive vomitus and abdominal distension. A gastric dilatation and volvulus was diagnosed. The dog underwent gastric derotation and incisional gastropexy. No intra- or post-operative complications occurred. Eight months following surgery, the dog was in excellent physical condition with no recurrence of clinical episodes of gastric dilatation. To the authors' knowledge, gastric dilatation and volvulus has not been previously reported in a puppy. This report underlines the importance of considering a prophylactic gastropexy in juvenile dogs with a known breed predisposition for gastric dilatation and volvulus.
Topics: Animals; Dog Diseases; Dogs; Female; Gastric Dilatation; Gastropexy; Intestinal Volvulus; Stomach Volvulus
PubMed: 31156256
DOI: No ID Found -
Annals of Surgery Oct 2021Define clinical spectrum and long-term outcomes of gut malrotation. With new insights, an innovative procedure was introduced and predictive models were established.
OBJECTIVES
Define clinical spectrum and long-term outcomes of gut malrotation. With new insights, an innovative procedure was introduced and predictive models were established.
METHODS
Over 30-years, 500 patients were managed at 2 institutions. Of these, 274 (55%) were children at time of diagnosis. At referral, 204 (41%) patients suffered midgut-loss and the remaining 296 (59%) had intact gut with a wide range of digestive symptoms. With midgut-loss, 189 (93%) patients underwent surgery with gut transplantation in 174 (92%) including 16 of 31 (16%) who had autologous gut reconstruction. Ladd's procedure was documented in 192 (38%) patients with recurrent or de novo volvulus in 41 (21%). For 80 patients with disabling gastrointestinal symptoms, gut malrotation correction (GMC) surgery "Kareem's procedure" was offered with completion of the 270° embryonic counterclockwise-rotation, reversal of vascular-inversion, and fixation of mesenteric-attachments. Concomitant colonic dysmotility was observed in 25 (31%) patients.
RESULTS
The cumulative risk of midgut-loss increased with volvulus, prematurity, gastroschisis, and intestinal atresia whereas reduced with Ladd's and increasing age. Transplant cumulative survival was 63% at 10-years and 54% at 20-years with best outcome among infants and liver-containing allografts. Autologous gut reconstruction achieved 78% and GMC had 100% 10-year survival. Ladd's was associated with 21% recurrent/de novo volvulus and worsening (P > 0.05) of the preoperative National Institute of Health patient-reported outcomes measurement information system gastrointestinal symptom scales. GMC significantly (P ≤ 0.001) improved all of the symptomatology domains with no technical complications or development of volvulus. GMC improved quality of life with restored nutritional autonomy (P < 0.0001) and daily activities (P < 0.0001).
CONCLUSIONS
Gut malrotation is a clinicopathologic syndrome affecting all ages. The introduced herein definitive correction procedure is safe, effective, and easy to perform. Accordingly, the current standard of care practice should be redefined in this orphan population.
Topics: Adolescent; Adult; Child; Child, Preschool; Cohort Studies; Digestive System Surgical Procedures; Female; Humans; Infant; Infant, Newborn; Intestinal Volvulus; Male; Plastic Surgery Procedures; Survival Rate; Treatment Outcome; Young Adult
PubMed: 34506313
DOI: 10.1097/SLA.0000000000005072 -
The Malaysian Journal of Pathology Apr 2021Small bowel volvulus is defined as the torsion of the small intestine, potentially leading to bowel obstruction, gangrene and perforation. It is a rare condition,...
BACKGROUND
Small bowel volvulus is defined as the torsion of the small intestine, potentially leading to bowel obstruction, gangrene and perforation. It is a rare condition, especially in adults.
CASE PRESENTATION
A 30-year-old man was retrieved from the jungle with severe weight loss and abdominal symptoms. He succumbed to death despite 22 days of intensive medical treatment. An autopsy revealed a ruptured gangrenous ileal volvulus with peritonitis and subdiaphragmatic abscess. Further laboratory analysis detected systemic Candida tropicalis and intestinal gramnegative bacterial sepsis, systemic Zika virus viremia, leptospirosis complicating rhabdomyolysis and disseminated intravascular coagulopathy, Type I Herpes Simplex virus infection of the tongue and upper gastrointestinal tract. The cause of death was the ruptured ileal volvulus, complicated with upper gastrointestinal bleeding due to Herpes simplex virus esophagitis in a malnourished patient with resolving leptospirosis and underlying Zika virus co-infection.
CONCLUSION
Rare clinical scenarios of adult-onset intestinal volvulus with concomitant multiple infections precludes clinical diagnosis and early treatment, leading to devastating consequences of clinical outcome. The positive clinical and postmortem correlation is a good learning lesson in many disciplines of medicine and science.
Topics: Adult; Autopsy; Humans; Intestinal Obstruction; Intestinal Volvulus; Leptospirosis; Male; Zika Virus; Zika Virus Infection
PubMed: 33903310
DOI: No ID Found -
The American Journal of Case Reports Sep 2020BACKGROUND Wandering spleen is a rare condition in which the spleen lacks the usual peritoneal attachments, resulting in increased intra-abdominal mobility.... (Review)
Review
BACKGROUND Wandering spleen is a rare condition in which the spleen lacks the usual peritoneal attachments, resulting in increased intra-abdominal mobility. Complications can occur due to the torsion of the splenic vascular pedicle, resulting in symptoms ranging from an incidental finding to an acute abdomen as a result of an ischemic necrosis of the spleen. CASE REPORT We present the case of a 25-year-old female patient who presented with a recurring abdominal pain associated with serum lipase and C-reactive protein elevation. The computed tomography scan revealed torsion of the splenic pedicle and hypoperfusion of the spleen. A surgical exploration was performed and a wandering spleen was diagnosed perioperatively. It was characterized by the lack of peritoneal ligaments, thus resulting in a splenic volvulus. A splenectomy was carried out due to the definite ischemic necrosis of the spleen. CONCLUSIONS The diagnosis of this rare condition can be very challenging since it can be presented with a vast variety of symptoms, mimicking other abdominal pathologies. The intermittent nature of an ultimate splenic torsion can add to the diagnostic challenge. Medical literature concerning the wandering spleen and knowledge about this pathology originates mainly from individual case reports. Despite the evolving diagnostic modalities available, this rare and ambiguous disorder remains misdiagnosed, and a high index of suspicion is needed for the appropriate diagnosis to be established.
Topics: Abdomen, Acute; Adult; Female; Humans; Intestinal Volvulus; Splenic Diseases; Torsion Abnormality; Wandering Spleen
PubMed: 32868755
DOI: 10.12659/AJCR.925301 -
The American Journal of Case Reports May 2024BACKGROUND Jejunal diverticulosis are false diverticula of the small bowel that form from outpouching of the mucosa and submucosa. They are pulsion diverticula that are...
BACKGROUND Jejunal diverticulosis are false diverticula of the small bowel that form from outpouching of the mucosa and submucosa. They are pulsion diverticula that are often asymptomatic and can be found incidentally during surgery. In some instances, jejunal diverticula could result in intestinal obstruction. Small intestinal volvulus is an uncommon cause of small bowel obstruction that results in a closed loop obstruction and is an indication for emergent surgical intervention. CASE REPORT We report a case of an 84-year-old man who presented to the Emergency Department with abdominal pain and generalized weakness. A preoperative computerized tomographic scan demonstrated a closed loop small bowel obstruction with mesenteric swirling. The patient was taken for a diagnostic laparoscopy, which revealed extensive proximal jejunal diverticulosis and a volvulus of the involved jejunum. An exploratory laparotomy was warranted for safe detorsion of the small bowel and resection of the diseased segment. The small bowel was successfully detorsed, with resection of the involved jejunum. Intestinal continuity was established by a primary side-to-side anastomosis. CONCLUSIONS Jejunal diverticula have been reported in the literature as a cause of small bowel obstructions, and very few reports exist of concurrent small bowel volvulus. In very rare instances, both of these conditions can coexist. There should be prompt surgical intervention in all cases of closed loop small bowel obstructions to prevent intestinal ischemia, perforation, and sepsis.
Topics: Aged, 80 and over; Humans; Male; Diverticulum; Intestinal Obstruction; Intestinal Volvulus; Intestine, Small; Jejunal Diseases; Tomography, X-Ray Computed
PubMed: 38693681
DOI: 10.12659/AJCR.943376 -
Annals of the Royal College of Surgeons... Sep 2016Introduction Malrotation of the midgut and appendiceal mucocoele are both extremely rare pathological conditions in adults. To our knowledge, there are only two reported...
Introduction Malrotation of the midgut and appendiceal mucocoele are both extremely rare pathological conditions in adults. To our knowledge, there are only two reported cases in the English literature with a combination of both conditions. Case History A 65-year-old man presented with a 10-day history of upper abdominal pain associated with abdominal bloating and weight loss. He was otherwise fit and healthy with no significant past medical history. On examination, his abdomen was soft with tenderness and palpable fullness over the left upper quadrant. The initial blood test, chest x-ray and abdominal x-ray demonstrated no significant abnormality. Computed tomography showed a 17cm x 8cm x 6cm elongated cystic mass with possible malrotation of the intestines. Histopathology showed a low grade mucinous tumour of the appendix. At 12 months following surgery, there was no evidence of recurrence or postoperative complications and the patient was discharged from the care of the colorectal team. Conclusions We report a patient with a combination of two rare conditions. This case illustrates how a combination of pathologies can present a challenge to the unwary general surgeon.
Topics: Aged; Appendix; Cecal Diseases; Digestive System Abnormalities; Humans; Intestinal Volvulus; Male; Mucocele; Tomography, X-Ray Computed
PubMed: 27269433
DOI: 10.1308/rcsann.2016.0184 -
Acta Medica Portuguesa 2011Volvulus of the transverse colon continues to be a rare medical problem in the bibliographic medical revisions of large bowel obstructions (1%), being frequently... (Review)
Review
Volvulus of the transverse colon continues to be a rare medical problem in the bibliographic medical revisions of large bowel obstructions (1%), being frequently excluded of the differential diagnosis. However it is associated with higher morbid-mortality than the commonest cecal and sigmoid volvulus, making urgent a rapid diagnostic and chirurgical intervention. The authors present a case of this entity emphasizing the imagiologic diagnostic aspects and a bibliographic revision.
Topics: Abdomen, Acute; Aged, 80 and over; Colon, Transverse; Colonic Diseases; Humans; Intestinal Volvulus; Male; Radiography
PubMed: 22521021
DOI: No ID Found -
Journal of Gastrointestinal Surgery :... Jan 2021
Topics: Anastomosis, Surgical; Colitis, Ulcerative; Colonic Pouches; Humans; Ileum; Intestinal Volvulus; Proctocolectomy, Restorative
PubMed: 32378094
DOI: 10.1007/s11605-020-04630-6 -
Asian Journal of Surgery Jan 2017A 1-year-old boy with no underlying disorder presented with non-bilious vomiting since 4 days before admission. He was referred to our hospital and was diagnosed with a... (Review)
Review
A 1-year-old boy with no underlying disorder presented with non-bilious vomiting since 4 days before admission. He was referred to our hospital and was diagnosed with a small bowel obstruction due to an intraabdominal tumor. Laparotomy revealed an intestinal volvulus with a soft and lobulated tumor arising from the mesentery. The resected tumor with a small part of the small bowel was diagnosed as lipoblastoma histologically. From a literature review, mesenteric lipoblastoma with an intestinal volvulus showed different characteristics such as greater frequency of vomiting and less frequency of abdominal mass as clinical symptoms, and the size of the tumor was smaller than that of the tumor without the intestinal volvulus.
Topics: Humans; Infant; Intestinal Volvulus; Intestine, Small; Lipoblastoma; Male; Mesentery; Peritoneal Neoplasms
PubMed: 28034384
DOI: 10.1016/j.asjsur.2013.01.009 -
Journal of Investigative Medicine High... 2020Sigmoid volvulus is a rare condition seen during pregnancy with high maternal and fetal morbidity and mortality. We report a case of a young 26-year-old woman,...
Sigmoid volvulus is a rare condition seen during pregnancy with high maternal and fetal morbidity and mortality. We report a case of a young 26-year-old woman, primipara, in her third trimester who presented with recurrent sigmoid volvulus at both 30 and 32 weeks of gestation. She underwent successful repetitive endoscopic decompression on both admissions with uneventful recovery. Endoscopic evaluation is safe in pregnancy and uncomplicated volvulus. It allows for diagnostic confirmation and assessment of complications; and it has successful outcomes in the presence of a multidisciplinary team.
Topics: Adult; Colon, Sigmoid; Endoscopy, Gastrointestinal; Female; Humans; Intestinal Volvulus; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Recurrence
PubMed: 33238755
DOI: 10.1177/2324709620975939