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

In developed countries, intestinal volvulus in children is most frequently due to malrotation. To review the experience in Nigeria, a retrospective analysis of 28 patients managed over 25 years at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, was undertaken. There were 22 boys and 6 girls with an age range of 4 days to 14 years (median 4 years). There were equal numbers over and less than 5 years of age. Vomiting (89%) and abdominal distension (79%) were the most prominent features. Thirteen children (46%) had fever, associated with bowel gangrene in 5, while 8 (29%) presented with severe dehydration and shock. A plain abdominal radiograph was the only investigation performed, but the features were not specific for volvulus. In 11 children (39%) the volvulus was idiopathic, in 9 (32%) due to adhesions or bands, in 5 (18%) to malrotation, and in 1 each a Meckel's diverticulum, internal herniation, and ventriculoperitoneal shunt. Twenty-three patients had a small-bowel, 4 sigmoid, and 1 caecal volvulus. The bowel resection rate for gangrene was 46% (small bowel 9, sigmoid 3, caecum 1). All patients with malrotation had Ladd's procedure performed. Wound infections occurred in 10 patients (36%), complete wound dehiscence in 1, and recurrence in 1 (idiopathic terminal ileal volvulus). The mortality was 21%, mostly from overwhelming infection (2 neonates, 11-year-old, 3 >/= 5 years). Intestinal volvulus in our environment differs in aetiology from other reports. The resection rates are similar, however. This condition carries high morbidity and mortality.
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PMID:Intestinal volvulus: aetiology, morbidity, and mortality in Nigerian children. 1066 35

Sigmoid volvulus is a common cause of large-bowel obstruction in elderly individuals, but is quite rare in childhood. We report six cases in patients under 20 years of age. One had Hirschprung's disease. Gangrenous sigmoid colon was found in three cases and resection was performed. Sigmoidopexy (one case) and extraperitonealization (two cases) were performed for viable sigmoid colon. There were no recurrences after 5.7 years of follow-up.
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PMID:Sigmoid volvulus in childhood: report of six cases. 1066 63

The epidemiology and clinical pattern of sigmoid volvulus are well defined. Although clinical manifestations of acute volvulus are often clear-cut, diagnostic doubt is not uncommon and, if gangrene supervenes, mortality rises appreciably. While gangrene requires resectional surgery, the management of the viable colon related to a volvulus episode has a variety of options. These, particularly non-resectional alternatives, require more critical reappraisal in the light of advances in minimally invasive techniques.
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PMID:The management of sigmoid volvulus. 1132 42

Ten years after colonoplasty using the left colon for impassable corrosive stricture of the esophagus, a 27-year-old woman developed volvulus and gangrene of the remaining intra-abdominal colon. It was resected and colostomy was done. In the second stage, after 3 months, the ascending colon and cecum were mobilized and anastomosed to the rectal stump. Eight years later, the patient is asymptomatic.
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PMID:Volvulus and gangrene in intra-abdominal colon after colonoplasty for esophageal stricture. 1105 90

Intrathoracic gastric volvulus is a very rare surgical emergency. Early diagnosis and treatment are of great importance to prevent gastric gangrene and perforation or gastric obstruction and dilation, which may lead to cardiorespiratory arrest. We report two infants who presented with intrathoracic gastric volvulus. This was associated with recurrent diaphragmatic hernia in one and congenital paraoesophageal hernia in the other. Aspects of diagnosis and treatment are also discussed.
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PMID:Intrathoracic gastric volvulus in infancy. 1226 57

Six children with acute intestinal obstruction from sigmoid volvulus (SV) (n=2) and ileosigmoid knotting (ISK) (n=4) are reported. The median age at presentation was 4.5 years (range 2 weeks-15 years). Abdominal pain, distention, vomiting, and constipation were the main features. Two patients with ISK had bowel gangrene. In three children there was no identifiable cause; two had a narrow attachment of the sigmoid mesocolon with redundant colon and one had adhesive bands. Treatment was by resection and colostomy in five cases and derotation of the torted colon in one. One child with SV died following a wound infection. There was no recurrence. SV and ISK are uncommon in children. There are usually no features specific for these conditions, and the diagnosis is established at laparotomy. The prognosis is good when there is aggressive resuscitation and prompt surgery.
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PMID:Sigmoid volvulus and ileosigmoid knotting in children. 1172 56

Cecal volvulus is second only to sigmoid volvulus in its frequency of occurrence. Diagnostic doubt is not uncommon in cecal volvulus; nonoperative decompression is rarely achievable; and if gangrene supervenes, mortality rises appreciably. Resection is mandatory for gangrene and a grossly distended, thin-walled cecum. Cecopexy and cecostomy seem less-effective and more morbid options than resection and anastomosis for viable bowel. However, their role needs reappraisal in the light of advances in minimally invasive techniques.
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PMID:The management of cecal volvulus. 1185 42

The aim of the present study was to retrospectively evaluate the results of resection for volvulus of the right colon. Over a 17-year period, 45 patients (33 women) of mean age 64 years were admitted with acute right colon volvulus. Preoperative diagnosis was obtained in 53% of the cases. A right hemicolectomy was performed in all the cases, with primary anastomosis in 43 cases and double ileal and transverse stomy in 2 cases. Gangrene was observed in 23 patients (51%). Postoperative mortality was 6.6% (3 patients) due to septic shock and multi-organ failure in 2 cases, and respiratory failure in the other cases. Postoperative morbidity was 20% (9 patients), including 2 cases of anastomotic leaks. On the basis of this study and a review of the literature, it appears that right hemicolectomy is the treatment of choice for volvulus of the right colon, as it avoids all risk of recurrence and mortality is lower than that obtained with conservative treatment.
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PMID:Results of resection for volvulus of the right colon. 1240 54

A retrospective study on 18 patients with cecal volvulus surgically treated was made. Demographics and clinical data, as well as treatment were determined from clinical reports. The operative procedures employed were cecostomy (56%), cecopexy (22%) and right colectomy (22%). The length of follow up averaged 63 months and there was one recurrence. The Authors suggest that cecostomy should be employed in patients with viable bowel, and resection should be limited to cases with gangrene.
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PMID:[Cecal volvulus]. 1265 17

Intestinal obstruction is a common cause of emergency surgical admission. The most frequent causes are well known and may often be safely treated conservatively in the first instance. The rarer causes of intestinal obstruction require prompt diagnosis and surgery if they are not to progress rapidly to strangulation and gangrene. One such cause is the ileosigmoid knotting, which is associated with a high morbidity and mortality. With increasing travel activity and population migration this condition is now being seen outside its original geographical sites of origin. This article focuses on the aetiology, pathophysiology, clinical features, investigations and the various surgical options for the management of the ileosigmoid knotting. Studies and case reports in English literature were identified by PubMed, ISIS, Embase and CAS searches between the years 1966-2004 using the following free text keywords: ileo- sigmoid knotting, ileosigmoid knot(ting), intestinal knot(ting), compound volvulus and double volvulus. All the reference lists were reviewed to retrieve additional articles. Aggressive resuscitation, prompt surgical relief of obstruction, appropriate antibiotics, accurate intra-operative assessment of the viability of the involved loops of intestine and the use of modern postoperative intensive care will help reduce the mortality and morbidity associated with this life threatening condition.
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PMID:Ileosigmoid knotting. 1520 62


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