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

We report a case of Bochdalek's hernia with volvulus of the stomach and extrapulmonary sequestration in an adult. A 27-year-old woman presented acute respiratory failure, pain in the left side of the chest and recurrent vomiting of sudden onset. Upon examination there was pain in the left hypochondrium that was not tolerated in decubitus position. A chest film showed an "arch" at the base on the left side and an upper gastrointestinal series revealed volvulus of the stomach. After a left thoracotomy, the stomach, spleen and greater omentum were found displaced into the thoracic cavity. After the viscera were confined to the abdomen, the hernia was repaired and the pulmonary sequestration was removed. Two years later, the patient was asymptomatic and a chest film was normal.
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PMID:[Bochdalek's hernia in an adult with stomach volvulus and extrapulmonary sequestration]. 762 24

In this paper we discuss the actual role of imaging in surgical management of urgency in colon-rectal pathology. We have considered four different kinds of pathologic: obstruction; occlusion; inflammatory and infections pathology; vascular pathology: In the first group an accurate radiologic evaluation in different decubitus is necessary. In negative or doubt cases, but with clinic highly suggestive for the presence of pathology, a CT examination is mandatory. In the second group, an accurate preliminary radiologic evaluation with plain radiographs of the abdomen is also necessary. With the use of contrast agents, it is possible to assess the level and the possible cause of the occlusion; at least, in some cases, (e.g. volvulus) a CT examination can be useful. The third group is concerning about inflammatory and infectious pathology: in these cases new radiologic technologies, like US and CT, play a significant role in their detection, evaluation of extension, assessment of complications. Especially in acute diverticulitis and acute appendicitis, the diagnosis is based essentially on clinical examination; and endoscopic confirmation is not possible in most cases. In all these cases, the radiologist can give to the surgeon an accurate evaluation of the pathology, with US or CT. The last group is about vascular pathology: at the moment angiography plays a secondary role in diagnosis, the use of endoscopy being more and more frequent; nevertheless, interventional radiologic procedures are successful in a lot of cases, thanks to their accuracy, low invasiveness and low percentage of complications.
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PMID:[Emergencies in colorectal surgery: diagnostic imaging]. 892 29

A 55-year-old woman had recurrent bouts of low substernal and epigastric pain radiating into the interscapular region. A hepatobiliary scan initially showed what was believed to be a dilated common bile duct and nonvisualization of the gallbladder. A delayed image obtained after having the patient move about revealed the presence of a filled gallbladder and normal common bile duct. The combination of recurrent pain with this scintigraphic picture may be representative of a floating gallbladder or an incomplete torsion with spontaneous detorsion. This case is presented to describe the scintigraphic appearance of a mobile gallbladder that may be prone to volvulus and to emphasize the importance of obtaining decubitus or oblique views at the end of a hepatobiliary study in selected cases of unusual findings.
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PMID:Floating gallbladder: a questionable prelude to torsion: a case report. 1069 12

Small-bowel volvulus around the superior mesenteric artery is a very unusual cause of small-intestinal obstruction, which may result in intestinal ischemia and necrosis. A 45-year-old woman, who had received a living-donor liver transplant with a right lobe graft for fulminant hepatic failure 5 years earlier, underwent a liver biopsy and was placed in the right decubitus position. Abdominal pain, high fever, tachycardia, and altered mental status developed quickly, suggesting abdominal sepsis. Computed tomography (CT) showed a "target sign," representing a counter-clockwise rotation of the mesenteric pedicle. However, without laparotomy, the symptoms subsided completely within 12 h by her lying strictly in the left decubitus position. A second CT scan showed an orthotopic untwisted jejunum. Although many complications associated with percutaneous liver biopsy have been described, to our knowledge this is the first report of positioning-associated intestinal volvulus after a liver biopsy.
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PMID:Small-intestinal volvulus around the superior mesenteric artery as an extremely rare positioning-associated complication after percutaneous liver biopsy. 1851 44

An 88-year-old woman with a history of stomach perforation and lumbar compression fracture was admitted to our hospital with a chief complaint of continuous vomiting, which she had experienced since the previous day. She showed vomiting, spontaneous pain and tenderness from the epigastric fossa through the left flank. In addition, she had marked kyphosis. On a CT scan, although the fornix was located in the abdominal cavity, the antrum and body had escaped into the thoracic cavity. A large volume of gastric content was observed. The patient was diagnosed with upside-down stomach from gastric volvulus and a hiatal hernia. Although we recommended surgery, the patient and her family did not agree with it. Thus, conservative therapy was selected. The patient's symptoms showed a significant improvement after the placement of a nasogastric tube, fasting and fluid therapy. After stabilization, an endoscopic examination was performed. The release of the gastric volvulus was confirmed and the nasogastric tube was removed. We instructed the patient to perform postprandial repositioning, which was based on the running shape of the digestive tract with the goal of achieving the passage of food and preventing a relapse of vomiting. The patient was instructed to first place herself in the right lateral decubitus position and then the prone position after eating. There was no recurrence of vomiting after the patient resumed eating. She was therefore discharged from our hospital. Upside-down stomach is usually an indication for surgery. However, in elderly patients, the fixation of the stomach to the abdominal wall has been reported to occur after endoscopic reduction, and conservative treatment was thus selected in this case.We herein reported a case in which postprandial repositioning was used to treat upside-down stomach.
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PMID:A case of upside-down stomach that was effectively treated by postprandial repositioning. 2820 90