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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chilaiditi's sign is a radiographic term used when the hepatic flexure of the colon is seen interposed between the liver and right hemidiaphragm. When symptomatic, this is Chilaiditi's syndrome. We report a case of Chilaiditi's syndrome associated with transverse colon volvulus. A 64-yr-old male presented with abdominal pain, vomiting, and constipation. Barium enema demonstrated complete colonic obstruction, leading to operative decompression and right hemicolectomy. This is the second case in the English literature of transverse colon volvulus associated with Chilaiditi's syndrome. Colonic elongation and laxity of colonic and hepatic suspensory ligaments are the principal predisposing factors to these two entities.
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PMID:Transverse colon volvulus and associated Chilaiditi's syndrome: case report and literature review. 894 99

A study of one hundred and forty-two patients with acute intestinal obstruction over a period of ten years (January 1985-December 1994) at Wesley Guild Hospital was undertaken to determine the pattern and outcome of this problem in a tropical African population. There was a preponderance of males over females; ratio 1.7:1. Mean age was 33 years and over half of the patients were aged between two and 30 years. There was a second peak age incidence among elderly patients between 50-80 years. Abdominal pain, vomiting and constipation were common symptoms, while abdominal distension and tenderness were common clinical findings. Intraperitoneal adhesions were responsible in 41.5%; there was associated intestinal volvulus in 25.4% of the cases of intraperitoneal adhesions. In 16.9%, strangulated external hernia was responsible for acute intestinal obstruction. Small intestinal volvulus was encountered in 20 cases (14.1%) and associated with adhesion in 75% of the cases. Intussusception occurred in 14.1% of cases of which 70% of the patients were below the age of 15 years. In 15 (10.6%) patients, there were volvulus of the sigmoid colon, with 80% (12 patients) having gangrenous bowel segments. Ascaris were responsible in 3.5% of the patients and large bowel tumour in 2.8%. Other rare causes were internal hernia and ileal pseudo obstruction. Adhesiolysis and intestinal resection were the commonest operative procedures. Common complications were wound infection in 16.2%, postoperative fever in 10.6% and chest infection in 9.1%. A mortality rate of 8.4% was recorded.
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PMID:Changing pattern of acute intestinal obstruction in a tropical African population. 899 63

We report here two patients with volvulus of the small bowel after laparoscopic cholecystectomy (LC). There has been only one case report of a similar condition after LC in the English literature; the patient had malrotation of the midgut. Both patients we are reporting had previous pelvic surgery resulting in intraabdominal adhesions. Volvulus had occurred along an axis between the mesenteric attachment and the adhesion to the parietal peritoneum of the involved loop of small bowel. The creation of pneumoperitoneum could conceivably allow rotation to occur. One patient presented with signs of peritonitis from a gangrenous segment of small bowel. The other presented with continued abdominal pain after surgery. Definitive diagnosis was made only at laparotomy. Previous surgery is considered a relative contraindication to LC, although the incidence of morbidity and conversion to open procedure appear not to be influenced by previous surgery. Surgeons should be aware of volvulus as a complication after LC in patients who had previous abdominal surgery.
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PMID:Volvulus of the small bowel: an uncommon complication after laparoscopic cholecystectomy. 945 66

The previous reports concerning the computed tomographic (CT) appearances of small bowel diverticulum are usually limited to those of diverticulitis. We present the CT findings of uncomplicated, large small bowel diverticulum in five patients. An interesting coexistence of large small bowel diverticulum and small bowel volvulus will be mentioned. Four patients had recurrent abdominal pain in the past 2 years.
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PMID:CT of large small-bowel diverticulum. 951 98

A 78-year-old Chinese woman presented with recurrent postprandial abdominal pain. Computerised tomography revealed a small bowel tumour causing volvulus of a segment of the small bowel. Laparotomy confirmed an extraluminal ileal tumour with partial volvulus of the involved small bowel segment. Small bowel resection was done. Histological and ultrastructural studies confirmed a gastrointestinal autonomic nerve tumour. We review the medical literature on this rare tumour.
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PMID:Gastrointestinal autonomic nerve tumour presenting as small bowel volvulus: a rare disease with a rare presentation. 953 9

Colonic volvulus in children is a rare, but serious and important differential diagnosis in acute abdominal illness. Our patient with Cornelia de Lange's syndrome, was admitted with an acute onset of abdominal pain and in a critical condition. Explorative laparotomy revealed a caecal volvulus with necrosis of the distal ileum, caecum and proximal colon. The syndrome is characterized by typical facial expression, both growth and mental retardation, and various gastrointestinal and cardiac anomalies. Predisposing factors contributing to volvulus in this syndrome are mental retardation and a higher incidence of malrotation and nonfixation of the caecum and ascending colon. The parents of children with Cornelia de Lange's syndrome should therefore be counselled so that they are able to provide essential information in the event of their children experiencing acute illness.
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PMID:[Cecal volvulus as a complication in Cornelia de Lange syndrome. A case report and literature review]. 961 83

Abdominal distention and metabolic acidosis are common in critically ill infants and children, and can be manifestations of an intra-abdominal catastrophe. This series demonstrates the value of bedside sonography (US) in this difficult assessment. Eight infants and children presented with the above situation. Seven were immediately post-cardiopulmonary resuscitation and none had antecedent histories of abdominal pain or bilious vomiting. Abdominal radiographs could not rule out intra-abdominal pathology such as ischemic bowel. Review of all laboratory and radiological data showed US to be a discerning modality for acute bowel pathology. A characteristic pattern of echogenic ascites, thickened bowel wall, dilated, fluid-filled bowel lumen, and lack of peristalsis was seen in those children with gangrenous bowel. Sonographic examination accurately predicted the status of the bowel in all patients. Four patients survived: two had segmental ileal necrosis, one had localized gangrene of the jejunum (twice), and one had necrotic bowel from a closed-loop obstruction. The four who died had malrotation with volvulus (two), superior mesenteric venous thrombosis, and one was immunocompromised with pulmonary aspiration. We conclude that bedside US can be extremely valuable as an adjunct in assessing the abdomen and diagnosing gangrenous bowel in critically ill infants and children.
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PMID:Multidisciplinary evaluation of the distended abdomen in critically ill infants and children: the role of bedside sonography. 963 16

Although rare in childhood, gastric volvulus and wandering spleen share a common etiology: congenital absence of intraperitoneal visceral attachments. We report an unusual case of a patient who presented with three episodes of intractable vomiting and abdominal mass but no abdominal pain. A diagnosis could not be made until the third episode because the gastric volvulus resolved each time on placement of a nasogastric (NG) tube before any further tests could be done. During the third episode, diagnostic imaging was performed before inserting an NG tube, and the diagnosis of a mesenteroaxial gastric volvulus and an abnormally positioned spleen was made. Although both conditions are caused by abnormalities of fixation, the association of gastric volvulus and wandering spleen has been reported only once before.
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PMID:Gastric volvulus and wandering spleen. 967 48

We herein present a patient with lipomatosis of the ileum including diverticulosis and volvulus. The patient presented with abdominal pain and vomiting. Preoperatively, we diagnosed lipomatosis with volvulus of the ileum based on the findings of abdominal ultrasonography (US) and computed tomography (CT). During surgery, the dilated ileum had rotated 720 degrees counterclockwise, and was found to contain lipomatosis and multiple diverticula. Although lipomatosis of the small bowel is extremely rare, it does show characteristic US and CT findings, thus making a preoperative diagnosis possible if this disease is included in the differential diagnosis.
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PMID:Lipomatosis of the ileum with volvulus: report of a case. 968 15

Intestinal obstruction in pregnancy is rare, volvulus being the commonest precipitating factor. It is a difficult diagnosis to make, because its symptoms mimic various pregnancy symptoms, but it commonly occurs in the third trimester or puerperium. A high index of suspicion is needed, and investigations for intestinal obstruction should be performed, especially when abdominal pain and vomiting persist. Careful evaluation of the abdominal cavity is also essential where a caesarean section is performed, particularly if there are unusual findings.
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PMID:Volvulus of the right colon in pregnancy. 974 55


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