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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The gallbladder volvulus is a very rare but extremely dangerous event. Described for the first time by Wendel in 1898, it affects more frequently the female sex, particularly in old age. The clinical case of a patient affected by this pathology, personally observed, is presented and the initial symptoms, diagnostic procedures and surgical intervention are described in detail. The anatomical and physiological backgrounds that permit the gallbladder to twist on its axis are analysed and finally the importance of an early diagnosis to avoid the complications of a bilious peritonitis is underlined. In any case the definite diagnosis is made more frequently during surgical intervention. An early intervention allows a rapid resolution of the clinical picture preventing the perforation of the viscus into the peritoneal cavity and the complication of a bilious peritonitis besides the spreading of the biliary stones into the abdominal cavity.
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PMID:[Volvulus of the gallbladder]. 970 83

Volvulus of the small intestine is a condition of bowel obstruction due to knotting and twisting of the small intestine. Two types of volvulus are described: 1) primary small intestinal volvulus where no predisposing factors exist, and 2) secondary volvulus where congenital or acquired conditions promote twisting of the small intestine. Over a 5-year period, 18 patients (eleven men and seven women) presenting volvulus of the small intestine are operated in the Emergency Surgery Clinic of the University Hospital "Queen Giovanna", representing 8.7 per cent of the total of 206 cases of small intestinal mechanical ileus (incarcerated herniations involving the small intestine are not included in the series). Primary volvulus is found in one patient. In those presenting secondary volvulus adhesions are the commonest underlying cause of small intestinal rotation--13 cases, next ranking primary tumor of the small intestine--one case, Meckel's diverticulum--one, carcinosis of peritoneum--one, and one patient with small intestine volvulation around colostomy. The most frequently encountered symptoms and laboratory examinations performed are analyzed. Intestinal necrosis is established in four instances (22 per cent). One patient dies of peritonitis and polyorganic insufficiency. Volvulus of the small intestine should be mandatorily considered in patients presenting mechanical ileus of the small intestine. Early operative intervention is a therapeutic approach contributing to preclude intestinal necrosis.
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PMID:[Volvulus of the small intestine]. 973 71

A staging classification is proposed by CT findings in 27 patients with acute abdomen, caused by inflammatory colonic non-parasitic pathology. Of the 17 patients with diverticular disease, 4 were stage A (edema/ischemia on thickness of the abdominal wall), 2 were stage B (partial intramural infarction on the abdominal wall) and 3 were stage C (abscess/peritonitis and obstruction/vascular strangulation). None of the patients in the series were stage D (ischemia/infarction of the colonic wall with dilatation). Of the 4 patients with ulcerative colitis, 3 were stage A and 1 in stage C. Of the 3 patients with Crohn's disease, 2 were stage A and 1 was in stage C. Classified as stage D were 1 pseudomembranous colitis, 1 volvulus and 1 idiopathic megacolon. Clinical severity was in parallel with CT stages that gave better information on the progression of the pathology. Staging by CT in acute abdomen caused by inflammatory colonic non-parasitic pathology could be useful in therapeutics.
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PMID:Acute abdomen caused by inflammatory colonic non-parasitic pathology: staging by CT. 1042 Oct 16

Among 36 neonates with intestinal perforations (IP) between 1975 and 1996, 5 had necrotizing enterocolitis (NEC IP) and 10 had focal IPs (FIP). A histologic review of the bowel near the perforations was made to see if there was any difference between cases of NEC IP and FIP. In 1 case of NEC IP, a defect in the musculature was found in addition to disappearance of the mucosal villi and dilated vessels or hemorrhage in the submucosa. Thinning or absence of the intestinal musculature and short villi in the mucosa was observed in 3 cases of FIP, but the acute ischemic changes in FIP were much less than in NEC IP. Hypothesizing that the defective musculature in FIP may be acquired by a vascular accident either before or after birth, we examined the histology of the latest consecutive infants diagnosed as having meconium peritonitis (MP) due to in-utero volvulus and perforation. In the tissue near the perforation, there was an identical focus of thinning and interruption of the musculature while the acute ischemic changes were minimal. We speculate that thinning or absence of the intestinal musculature in FIP may be a result of a transient ischemic event occurring in-utero and that FIP may develop in the damaged intestine after birth when it is fully dilated.
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PMID:The mechanism of focal intestinal perforations in neonates with low birth weight. 1063 31

We report case of primary volvulus of the small intestine and review 15 cases from the Japanese literature. A 56-year-old woman, with a history of appendectomy 30 years previously, was admitted with abdominal distension and signs of peritonitis. Abdominal computed tomography (CT) demonstrated a whirl-like pattern of the mesentery, showing the tightly twisted mesentery around the point of torsion. An emergency laparotomy revealed strangulation of the small intestine, from 200 cm anal to the Treitz ligament to 5 cm oral to the terminal ileum, caused by 360 degrees clockwise torsion. There was no adhesion caused by the previous operation nor were there any congenital anomalies. The strangulated intestine was removed and jejunocolonostomy was performed. The patient was discharged from hospital on day 39 after the operation. Primary volvulus of the small intestine was reported to be rare in Japan, but the mortality was 26%. Immediate diagnosis and surgical intervention is essential to achieve a good outcome. A whirl-like pattern of the mesentery is a typical sign of this condition on CT.
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PMID:Primary volvulus of the small intestine in an adult, and review of 15 other cases from the Japanese literature. 1063 42

A 77-year-old man known with chronic abdominal complaints and a malabsorption syndrome presented with ileus, peritonitis and air in the abdominal cavity. Surgery showed perforation of a jejunal diverticulum and extensive small bowel diverticulosis. The pathologic segment was surgically removed but the patient died afterwards of septic shock, diffuse intravascular coagulation and multi-organ failure. Small bowel diverticulosis has a prevalence of 0.3-2.5% and symptoms are present only in the minority of the cases. Apart from bacterial overgrowth and malabsorption, complications include bleeding, mechanical obstruction, volvulus and perforation. Diagnosis is difficult and mostly made by double-contrast radiology of the small bowel or during laparotomy. Treatment can be conservative in most patients; only in case of severe and persistent symptoms or complications like ileus, bleeding, perforation or volvulus, resection of the affected bowel segment is indicated.
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PMID:[Diverticulosis of the small bowel]. 1082 50

The objectives of this study were to determine the etiology and types of vagal indigestion (VI) occurring after right displacement of the abomasum or abomasal volvulus (RDA/AV), and the prognosis for each type. Data of cows presented for RDA/AV from a retrospective (n = 288) and a prospective (n = 132) study were used. Vagal indigestion occurred in 39 and 22 cows in each study, respectively. A necropsy was performed in 29 cases. Gastric compartment dilation compatible with VI type III or IV occurred in 23 cases. An abnormal gastric wall was detected in 22 cases. Peritonitis was present in 18 cows. Vagal nerve lesions were present in 5 out of 13 cases studied. Clinical, hematological, and necropsy results suggested a classification of VI with respect to presence or absence of peritonitis. Gastric wall damage, peritonitis and vagal nerve lesions appear important in the etiology. Considering peritonitis occurrence, antimicrobial therapy appears necessary in the treatment of RDA/AV.
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PMID:Etiology, forms, and prognosis of gastrointestinal dysfunction resembling vagal indigestion occurring after surgical correction of right abomasal displacement. 1106 35

Volvulus of the small bowel is not so frequent as is volvulus of the colon. A delayed diagnosis and surgical treatment result in high rate bowel infarction which can lead to perforation and stercoral peritonitis. If perforation does not take place, the infarcted bowel has to be resected causing multiple complications and mortality. The small bowel volvulus is caused by mesenteric lipoma in about 5% of cases. We present a 77-year-old man operated on for intestinal obstruction. The patient was admitted in a serious condition with a five-day history of abdominal pain and vomiting. On admission he vomited a small bowel content (miserere), he was dehydrated and with high blood urea and creatinine values. Plain X-ray showed a number of air fluid levels in the small bowel. At operation a small bowel volvulus caused by mesenteric lipoma (18 x 11 x 10 cm in diameter) with bowel infarction but without free perforation and peritonitis, was found. The tumour was removed together with 10 cm of resected bowel with end-to-end anastomosis. The recovery was uneventful. The patient is still symptom free.
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PMID:[Mesenteric lipoma causing volvulus of the small intestine]. 1108 23

A retrospective analysis was undertaken on 229 cases of acute surgical abdomen surgically managed at Yirgalem hospital from January to December 1997. Small intestinal obstruction ranked the first and it was mainly due to small intestinal volvulus. Acute appendicitis was the second in the rank. Large intestinal obstruction was the third and it was mainly due to sigmoid volvulus. Typhoid perforation, primary peritonitis, perforated gastroduodenal ulcer, abdominal tuberculosis and empyema of the gallbladder in that order were the other observed causes of acute surgical abdomen. Analysis based on the specific causes of acute abdomen is of great value for early diagnosis and prompt treatment in clinical practice.
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PMID:Pattern of acute abdomen in Yirgalem Hospital, southern Ethiopia. 1112 97

We report a case of in utero paracentesis of ascites in a fetus with meconium peritonitis due to volvulus at 34 weeks which resulted in the correction of an abnormal fetal heart rate pattern and enabled vaginal delivery by preventing abdominal dystocia. The intrauterine intervention also helped to establish the diagnosis and potentially reduced the respiratory compromise after birth.
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PMID:Changes in fetal heart rate pattern after intrauterine paracentesis in one twin with meconium peritonitis. 1153 73


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