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Query: UMLS:C0042961 (volvulus)
 4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ileosigmoid knotting, or compound volvulus, has not been reported previously in Australia. A 41 year old woman of Anglo-Saxon origin presented with a short history of extreme abdominal pain that was out of proportion to her physical findings. At operation it was found that her entire ileum was tightly knotted around the redundant, twisted sigmoid colon. Both closed loops were gangrenous and it was impossible to unravel the bowel. She recovered uneventfully following resection and primary anastomosis of both portions of the intestine. Most patients with this uncommon condition have been reported from Finland and eastern Africa. An arrangement of the small bowel and sigmoid colon on long, narrow mesenteries would appear to be a prerequisite. The brevity of the history and the severity of the abdominal pain call for early laparotomy. Prolonged attempts to untie the knot are dangerous. It is safer to divide the ileum at the knot and resect it in order to release the sigmoid colon. Primary anastomosis is feasible where the history is short and the uninvolved intestine is clean and collapsed.
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PMID:Ileosigmoid knotting: a case report and review. 157 64

Gastric volvulus is a rare disease. We recently encountered a gastric volvulus associated with Bochdalek hernia and severe hypopotassemia. A 32-year-old woman experienced epigastric pain and recurrent vomiting. The changes of the electrocardiogram in this patient (K1.8mEq/l) were inverted T wave and ST depression. She was diagnosed as having gastric volvulus associated with Bochdalek hernia by chest X-ray films, contrast radiography of the upper digestive tract and thoraco-abdominal CT scans. Symptoms did not disappear with the administration of conservative therapy. At laparotomy, the stomach was rotated around its mesenteric axis in the sagittal plane. After operative repair, symptoms disappeared, and serum potassium level returned to normal. Gastric volvulus is rather easily diagnosed if its existence is kept in mind.
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PMID:[A case of Bochdalek hernia in an adult with volvulus of the stomach and hypopotassemia]. 189 66

A case of distal volvulus of the stomach as a cause of acute intestinal obstruction in a paraesophageal hernia is presented. The patient, an old woman aged 82, had been suffering from abdominal pain and vomiting for about 48 hours. She successfully underwent emergency operation for the reduction of hernia and plasty of the hiatus anterior the esophagus. On the basis of personal experience and review of literature data, stress is laid on the high incidence of paraesophageal hernia complications and the importance of early diagnosis and surgical repair is underlined.
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PMID:[Distal gastric volvulus as a cause of acute occlusion in paraesophageal hernia. Considerations on a clinical case]. 262 60

A case of a 61 year old woman with Ehlers-Danlos syndrome who developed recurrent gastrointestinal complications is reported herein. She has been followed by Kyoundo Hospital since 1965, when she originally underwent treatment for eventration of the diaphragm and a volvulus of the stomach at the age of 41. During the past 22 years she has experienced perforation of the colon three times and jejunal perforation once. This case was considered to be type II Ehlers-Danlos syndrome. We have found 12 other cases of Ehlers-Danlos syndrome with gastrointestinal complications in the Japanese literature. More thorough examination of Ehlers-Danlos syndrome cases may reveal more subclinical gastrointestinal abnormalities. We concluded from our experience and from the literature that when colonic perforation occurs in this syndrome, total colectomy and ileo-rectal anastomosis is reasonably indicated.
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PMID:Ehlers-Danlos syndrome complicated by eventration of the diaphragm, colonic perforation and jejunal perforation--a case report. 267 7

An 83-year-old woman, largely bedridden since a stroke 2 years before, was hospitalized because of upper abdominal pain, nausea and obstipation. She had regularly been taking laxatives of the anthraquinone type. She had a fever of 38.6 degrees C and leukocytosis (14,900/microliters). Radiological examination revealed volvulus of the sigmoid colon with ileus. As she vehemently refused an operation, it was attempted to reduce the volvulus endoscopically. At the first coloscopy the volvulus was untwisted. At that time there were already areas of necrosis in the rectosigmoid and descending sigmoid portions. As the volvulus recurred three days later, another coloscopic derotation was performed, this time with fixation of the sigmoid by three gastrostomy tubes for 20 days. The further course was uncomplicated, the patient had regular bowel movements and became free of fever and symptoms. The white cell count returned to normal and the intestinal mucosa healed histologically without scarring. There has been no recurrence for 10 months. The conventional treatment of volvulus of the sigmoid is decompression followed by sigmoid resection. This case describes for the first time the nonoperative treatment by percutaneous endoscopic colopexy.
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PMID:[Percutaneous endoscopic colopexy--a new treatment possibility for volvulus of the sigmoid]. 771 43

A 72-year-old woman had been experiencing upper abdominal pain and vomiting for 2 years. On physical examination the abdomen was swollen and pressure sensitive. She had a leukocytosis (11,400/microliter) and hypokalaemia (3.6 mmol/l). X-ray films of the chest and abdomen revealed a large gastric air-bubble with two fluid levels of different height and an elevated left diaphragm, findings which suggested gastric volvulus. Most of the fluid was evacuated via a nasogastric tube. The stomach interior was difficult to examine by gastroscopy: it was only after withdrawal of the gastroscope from the duodenum that a normal gastric architecture was demonstrated, the volvulus apparently having been reduced during the gastroscopy. The gastric mucosa showed ulcerations and erosions. Gastropexy by gluing together the peritoneal layers was undertaken via dual percutaneous endoscopic gastrostomy. The catheters were removed after 4 weeks when the ulcerations had healed. The patient has been free of symptoms for more than a year so far.
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PMID:[Treatment of an intermittent stomach volvulus using gastropexy via percutaneous endoscopic gastrostomy]. 798 66

The case of an 11-year-old girl with a history of chondrodysplasia punctata is reported. She presented with a clinical picture of abdominal pain and vomiting. At surgical intervention an organo-axial gastric volvulus was found and a single derotation was performed. Three weeks after discharge the patient presented abdominal distension and vomiting. In a plain abdominal X-ray film a gastric dilation was appreciated and a new volvulus was detected by means of a contrast radiogram. The diagnosis was confirmed at surgery and a gastropexy was performed without volvulus relapse.
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PMID:[Stomach volvulus in a female patient with chondrodysplasia punctata]. 799 20

During pregnancy, intestinal obstruction due to sigmoid volvulus is extremely rare. Only 73 cases have been reported. A 24-year-old black woman, gravida 2, para 1, presented during Week 36 of an otherwise uneventful pregnancy, with intermittent abdominal pain and constipation, and no history of nausea, vomiting, fever, chills, previous medical problems, or prior abdominal surgery. Her previous pregnancy was a spontaneous vaginal delivery of a normal full-term neonate. On examination, she was afebrile, with abdominal tenderness. Laboratory studies revealed elevated WBC count of 13,500. She was admitted and given a Fleet enema, with no result or change in abdominal pain. Pain worsened; reexamination of her cervix revealed 3 cm dilation. After Pitocin augmentation, a viable male infant with Apgars of 7 and 9 was delivered. Postpartum, abdominal pain continued, with worsening abdominal distention. Radiograph revealed a massively distended colon. Physical examination 12 hours postdelivery indicated peritonitis. Exploratory laparotomy revealed volvulated, gangernous, massively distended sigmoid colon. The sigmoid colon was resected and Hartmann's colostomy performed. She was discharged on postoperative Day 4. Sigmoid volvulus complicating pregnancy is an uncommon and potentially devastating development that should be suspected with worsening abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity.
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PMID:Sigmoid volvulus in pregnancy. 861 67

Acute gastric volvulus in infancy is a rare disorder and a surgical emergency. Prompt clinical suspicion and radiological assessment are essential for this life-threatening condition. We report a 3-month-old female case, admitted for an initial suspicion of an intestinal obstruction. She presented unproductive retching, respiratory distress, epigastric distension and lethargy. It was not possible to introduce a naso-gastric tube. A radiological contrast study showed an occluded cardio-esophageal junction without passage of barium, two gastric fluid levels and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia. Laparotomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia. The stomach volvulus was untwisted, the diaphragmatic defect was repaired after reduction of the herniated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.
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PMID:Acute gastric volvulus and congenital posterolateral diaphragmatic hernia. 916 58

A 45-year-old woman was incidentally suspected to have megacolon. Chest X-rays showed elevated left diaphragm due to colonic gas, and the heart was deviated to the midline. Barium enema revealed marked dilation of the sigmoid colon, confirming the diagnosis of megacolon. Maximal diameter of the sigmoid colon was 23 cm, but she had no gastrointestinal symptoms. During the work up for megacolon, the presence of myotonic dystrophy was suspected. She had hatchet face, but was not bald. Muscles of the neck and extremities were slightly atrophic. There was percussion myotonia of the tongue and both hands, and grip myotonia of the hands. Laboratory examinations showed impaired glucose tolerance and low level of serum IgG. EMG showed myotonic discharges and myopathic units in the limbs. Brain CT imaging revealed a thick skull. Cases of myotonic dystrophy associated with marked megacolon are rare in Japan. Megacolon presents a high risk for ileus, volvulus, and rupture, and myotonic dystrophy is associated with a high operative and anesthesic risk. Megacolon, therefore, is an important complication to look for in the management of myotonic dystrophy.
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PMID:[Myotonic dystrophy with marked megacolon: report of a case]. 939 35


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