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

Laparoscopic cholecystectomy has become the standard surgical technique for treating symptomatic gallbladder disease. Intestinal obstruction after laparoscopic cholecystectomy is unusual. We present the case of a 37-year-old man who underwent routine laparoscopic cholecystectomy for cholelithiasis using an American four-port technique. He was well 24 h postoperatively and was discharged. He presented 36 h later with clinical features of bowel obstruction. A sigmoid loop was seen on a plain abdominal radiograph. Laparotomy revealed distension of the large and small bowel to the level of the rectosigmoid junction and a sigmoid volvulus. This was reduced by releasing adhesions to lengthen the sigmoid mesentery. A primary sigmoid resection and anastomosis was not attempted due to luminal discrepancy and lack of bowel preparation. The patient underwent interval sigmoid colectomy 2 weeks later. A sigmoid volvulus following laparoscopic cholecystectomy has not been previously reported. It may be related to the induction of the pneumoperitoneum, combined with the lateral tilt of the table and a long redundant sigmoid colon. This case expands the range of potential complications associated with laparoscopic cholecystectomy and illustrates the need for continued vigilance after apparently routine procedures.
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PMID:Sigmoid volvulus after laparoscopic cholecystectomy. An unusual complication. 1220 Jun 65

Bouveret's Syndrome is obstruction of the duodenum secondary to an impacted gallstone, usually without the presence of pneumobilia. With the steadily increasing life expectancy, greater numbers of these cases are being seen. Gallstones enter the gastrointestinal tract following fistula formation between the gallbladder and an adjacent hollow viscus and may cause obstruction at any point along the intestinal tract. Duodenal obstruction is the least common and represents only a very small percentage of cases. The presenting signs of nausea vomiting, abdominal cramping, and the absence of abdominal distension should alert the clinician to pathology in the proximal small bowel. The purpose of this report is to heighten the awareness of the primary care physicians, emergency room doctors, and surgeons to this diagnosis in elderly patients so that it can be included in the differential with the usual causes of gastric outlet obstruction--including ulcer disease; neoplasm; gastric volvulus; and other enteroliths, such as bezoars. Early diagnosis is critical, as these cases require urgent surgical intervention. Early resuscitation, diagnosis, and treatment are essential for a successful outcome.
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PMID:Bouveret's syndrome: revisiting gallstone obstruction of the duodenum. 1462 Jul 10

Acute abdominal pain in children occurs often and requires rapid clarification. Hints as to the condition are often given by the first impression and the case history of the patient. When the clinical examination and laboratory results do not lead to a clear finding, imaging methods such as a sonography can clarify the case. The most common cause for abdominal pain in infants is acute enteritis, mostly brought about by rotaviruses. Additional diagnoses are abdominal hernia, malrotation, hypertrophic pyloric stenosis, invagination or gastroesophageal reflux. In school-age children, the classic finding is "appendicitis". This should be differentiated from constipation, gastritis, pancreatitis, sigmoid volvulus, bowel and intestinal obstruction or, perhaps, gallstone trouble.
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PMID:[Acute abdominal pain in childhood]. 1536 66

The case of a 73-year-old male patient come to the Emergency Department for epigastric pain, vomiting and blocked bowel movement is presented. Plain abdominal X-ray performed on emergency showed marked small bowel distention, and air-fluid levels suggestive of intestinal obstruction. CT was indicated to establish its precise site and cause. The presence of a gallstone was evidenced: gallstone ileus was diagnosed. Interestingly enough, at surgery the gallstone was not found; most likely it was expelled spontaneuously during the time elapsed between CT and surgery. Based on imaging findings and a review of the literature it was concluded that the study patient had a rare association of intestinal volvulus and gallstone ileus.
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PMID:Reasoned diagnostic approach to a case of small bowel obstruction. 1602 24

The short bowel syndrome is the result of a congenital or acquired loss of a large part of the small intestine. The most frequent causes of surgical resection of the intestine in infants are arterial or venous thrombosis, intestinal volvulus, necrotizing enterocolitis, and Crohn's disease. Symptoms include nutrient and electrolyte malabsorption, steatorrhea and diarrhea, which can result in failure to thrive. The consequences of extensive small bowel resections consist of nutritional deficiencies, gastric acid hypersecretion, nephrolithiasis, cholelithiasis and lactic acidosis. Of these, D-lactic acidosis is an infrequent but important complication because of the symptoms that it can produce. D-lactic acid in the human organism is generated by intestinal bacteria, D-lactate ingestion, or endogenous production in the methyl glycoxylase pathway. Neurological symptoms such as somnolence, ataxia or altered behavior in a patient with short bowel syndrome should make us think of D-lactic acidosis caused by bacterial overgrowth. We present the case of an 11-year-old boy with short bowel syndrome secondary to multiple resections during the postnatal period who was admitted to hospital for episodes of confusion and altered behavior. The diagnosis was lactic acidosis. Outcome was favorable due to prompt instauration of treatment.
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PMID:[D-lactic acidosis in an 11-year-old patient with short bowel syndrome]. 1660 77

Ascaris lumbricoides is one of the most common parasitic infestations of the gastrointestinal tract worldwide. During the intestinal phase of the disease, the adult worms usually remain clinically silent, sometimes causing a variety of non-specific abdominal symptoms. When present in large numbers, the worms may get intertwined into a bolus, causing intestinal obstruction, volvulus or even perforation. Occasionally, the adult Ascaris worm may migrate into the Vater's ampulla and enter the bile duct, gall bladder or pancreatic duct, leading to a variety of complications such as biliary colic, gallstone formation, cholecystitis, pyogenic cholangitis, liver abscess and pancreatitis. Imaging plays a significant role in showing the presence of worms and possible complications in intestinal as well as hepatobiliary ascariasis. This pictorial essay aims to illustrate various imaging features of ascariasis and its associated complications.
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PMID:Imaging of ascariasis. 1795 83

Intestinal obstruction involves a partial or complete blockage of the bowel which results in the failure of intestinal contents to pass through. The mechanical causes of obstruction may include the followings: hernias, postoperative adhesions or scar tissue, impacted feces, gallstones, tumors, granulomatous processes, intussusception, volvulus, foreign bodies, and etc. Hernias are the third leading cause of intestinal obstruction by 10% approximately. However, most hernias are the cases with abdominal wall, inguinal or internal hernia. Femoral, obturator, lumbar, or sciatic hernia as the cause of obsturction is rare. Furthermore, the cases accompanying soft tissue necrosis are seldomly reported. Herein, we report a case of intestinal obstruction caused by strangulated femoral hernia accompanying soft tissue necrosis in a 78-years-old female patient.
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PMID:[A case of intestinal obstruction caused by strangulated femoral hernia accompanying soft tissue necrosis]. 1815 68

Since its introduction in the early 1990s, the laparoscopic cholecystectomy has become the standard surgical intervention for cholelithiasis. The laparoscopic technique is being used in an increasing number of abdominal procedures. Intestinal volvulus is a rare complication of laparoscopic procedures, such as the laparoscopic cholecystectomy. A review of the literature revealed 12 reports of this complication occurring without a clear cause. Etiologic factors that have been postulated include congenital malrotation, previous surgery, and intraoperative factors, such as pneumoperitoneum, mobilization of the bowel, and patient position. In this paper, we review the literature for this rare complication and report on a case of cecal bascule (a type of cecal volvulus) occurring following the laparoscopic cholecystectomy. Of the 12 prior reports of intestinal volvulus following laparoscopic procedures, 8 of these followed the laparoscopic cholecystectomy, of which two were cecal volvulae. This is the first reported case of a cecal bascule occurring following the laparoscopic cholecystectomy.
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PMID:Intestinal volvulus following laparoscopic surgery: a literature review and case report. 1850 75

Bouveret's Syndrome is obstruction of the duodenum secondary to an impacted gallstone, usually without the presence of pneumobilia With the steadily increasing lie expectancy, greater number of these cases are being seen. Gallstones enter the gastrointestinal tract following fistula formation between the gallbladder and an adjacent hollow viscus and may cause obstruction at any point along the intestinal tract. Duodenal obstruction is the least common and represents only a very small percentage of cases. The presenting signs of nausea vomiting, abdominal cramping, and the absence of abdominal distension should alert the clinician to pathology in the proximal small bowel. The purpose of this report is to heighten the awareness of the primary care physician, emergency room doctors and surgeons to this diagnosis in elderly patients so that it can be included in the differential with the usual cases of gastric outlet obstruction--including ulcer disease, neoplasms, gastric volvulus, and other enteroliths, such as bezoars. Early diagnosis is critical, as these cases require urgent surgical intervention. Early resuscitation. Diagnosis, and treatment are essential for a successful outcome.
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PMID:[Bouveret' syndrome or secondary duodenal obstruction caused by gallstones. Case report]. 1869 20

There is a wide variety of uncommon and unusual gastrointestinal causes of acute abdominal and pelvic pain that may be prospectively diagnosed on computed tomography. We demonstrate 10 such diagnoses and briefly review the current computed tomography and clinical literature on intussusception occurring beyond early childhood, small bowel obstruction from internal hernia, cecal volvulus, intramural small bowel hemorrhage, Boerhaave's syndrome, gastrointestinal luminal foreign bodies, small bowel diverticulitis, hemoperitoneum secondary to abdominal tumor; gallstone ileus, and gallbladder torsion. Radiologists and clinicians need to be aware of these disorders, particularly with the widespread utilization of computed tomography (CT) in the management of patients with acute abdominal pain.
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PMID:Uncommon and unusual gastrointestinal causes of the acute abdomen: computed tomographic diagnosis. 1885 44


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