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

Gastric volvulus is a rare cause of respiratory distress and vomiting in neonates. This diagnosis was suspected in a 4 week old baby with acute respiratory distress accompanied with vomiting, from the results of an esophagogastroduodenal radiological examination. At operation a gastric volvulus was confirmed, associated with an anatomical malformation: absence of gastrosplenic omentum predisposing to gastric volvulus with mesenterio-axial rotation. Gastropexy was followed by an uncomplicated postoperative course. A literature review confirmed rarity of this affection and raised the problem of causes of repeated vomiting in the newborn and premature infant. An often incriminated lesion is gastric plicature, a radiological notion, whereas gastric volvulus is accompanied necessarily by an altered uptake of contrast in the stomach. Acute volvulus must be distinguished from other types of volvulus, notably that observed during hiatus hernia. Early diagnosis allows rapid surgical treatment by anterior gastropexy as recommended by most authors.
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PMID:[A case of acute gastric volvulus in a newborn infant]. 360 92

Usually, axial hiatus hernia is a common disorder that produces no symptoms and requires no treatment and in the few patients who do experience symptoms, simple nonoperative treatment measures suffice. The typical symptoms of reflux esophagitis are heartburn and nocturnal regurgitation. Most patients respond well to nonoperative treatment; any associated axial hiatus hernia is not the cause of the symptoms of reflux esophagitis and does not need treatment. In the very few patients who do need an operation, fundoplication conducted through the abdomen is recommended. In nonaxial hiatus hernia the symptoms of intermittent obstruction and bleeding are due to volvulus of the herniated stomach; volvulus produces a closed-loop obstruction, a potentially dangerous condition. Surgical repair should be undertaken when the diagnosis is made, just as for other hernias of the abdominal wall and for the same cogent reasons. Prosthetic reinforced repair conducted through the abdomen is preferred.
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PMID:Hiatus hernia and reflux esophagitis. 366 48

Gastric volvulus is torsion of the stomach, which can compromise the gastric orifices and result in either acute or chronic and intermittent symptoms. We believe that gastric volvulus, especially when partial or intermittent, may be more common than has been previously thought. The condition should be suspected in any patient who has a history of retching or vomiting and has a paraesophageal hiatus hernia or eventration of the diaphragm. The classic triad of retching, severe and constant epigastric pain, and difficulty in passing a nasogastric tube should suggest the presence of acute gastric volvulus. The diagnosis is confirmed by specific findings on the upper gastrointestinal series. Acute gastric volvulus is a surgical emergency. Definitive treatment of recurrent chronic gastric volvulus is usually surgical, although conservative measures may have limited success.
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PMID:Gastric volvulus. More common than previously thought? 376 30

Between 1960 and 1980, 53 patients with massive incarcerated hiatal hernia were treated surgically. In 24 of the 53 patients, there was an associated organoaxial volvulus. The following symptoms and signs, which are almost peculiar to massive, incarcerated hernias, were observed: postprandial precordial distress in 43 patients, upper gastrointestinal bleeding (manifest or occult) in 24 patients, severe dyspnea in 13 patients, and complete obstruction associated with organoaxial volvulus in 4. In only 1 of the 53 patients was the hernia of the true paraesophageal type with the esophagogastric junction remaining in its normal, intraabdominal location. The remainder were all believed to be advanced stages of an ordinary sliding hiatal hernia. Operative treatment consisted of gastroplasty and partial fundoplication in 36 patients, standard Belsey repair in 14, and transabdominal Nissen repair in 3. Gastroplasty and partial fundoplication were used much more frequently during the 1970s, when it was realized that there is a significant incidence of chronic peptic esophagitis and shortening in these patients. Postoperative complications were few in spite of the advanced age of many of the patients. There was one operative death. Only 1 patient was lost to follow-up, and of the 51 patients remaining for analysis, follow-up has extended from 1 to 16 years, with a mean of 6.2 years. No patient has developed recurrent precordial pain, evidence of upper gastrointestinal bleeding, iron deficiency anemia, or severe dyspnea. Seven patients have residual dysphagia; this condition is minimal in 5, and is significant in 2 who require interval esophageal dilation. Nine patients have symptomatic reflux, which is minimal in 5 patients, moderate in 2 patients, and severe in 2 others who were subsequently reoperated on. Contrary to popular concept, our observations indicate that almost all of these patients represent advanced degrees of sliding hiatal hernia with intrathoracic displacement of the esophagogastric junction. This implies a need for an adequate antireflux reconstruction in all patients undergoing operation, as well as an awareness that unanticipated cicatricial changes may be present in the distal esophagus and may prejudice the success of some of the standard hiatal repairs.
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PMID:Massive hiatal hernia with incarceration: a report of 53 cases. 660 Mar 88

A rare association of pneumoperitoneum induced by pneumatosis cystoides intestinalis with chronic mesenteroaxial volvulus of an irreducible stomach in a paraesophageal hiatus hernia is described. The importance of accurate radiologic work-up is emphasized. The possible significance of this association to explain the pathogenesis of pneumatosis cystoides intestinalis is discussed.
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PMID:Pneumoperitoneum induced by pneumatosis cystoides intestinalis associated with volvulus of the stomach. 744 22

Over a four year period, from August 1987 to July 1991, thirteen cases of chronic and recurrent gastric volvulus were encountered comprising six paediatric and seven adult patients. In none of the patients was the condition clinically suspected; diagnosis being made only at meticulous upper gastro-intestinal (UGI) barium series. The paediatric patients typically presented with obstructive symptoms of projectile vomiting especially after meals and failure to thrive. The adults had variable symptoms of dyspepsia, recurrent intermittent upper abdominal discomfort or pain, occasionally accompanied by vomiting or retching mimicking many different upper abdominal conditions, such as peptic ulcer, biliary tract or pancreatic disease but with negative findings at endoscopy and abdominal ultrasound scanning. All cases were organo-axial type of gastric volvulus. Associated conditions were small sliding hiatus hernia in two adult cases; partial small bowel malrotation in two cases, high jejunal obstruction also in two cases and congenital hip dislocation in one patient. An infant had umbilical hernia, previous meconium cyst and meconium peritonitis. The condition seems not as uncommon as previously thought; the key to diagnosis being constant awareness, a high index of clinical suspicion and a carefully performed UGI barium series especially during the attack of pain.
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PMID:Gastric volvulus: more common than previously thought? 765 6

The case of a 75-year-old man with a history of hiatal hernia, who develops an acute gastric volvulus 17 days after a superior lobectomy of the left lung, is described. No similar cases were found in literature.
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PMID:Gastric volvulus as a complication of a left superior lobectomy in a patient with pre-existing hiatal hernia. 796 59

Paraesophageal hernias comprise only 2-5% of all hiatal hernias, yet unlike the more common sliding hiatal hernia, paraesophageal hernias are prone to undergo volvulus, with obstruction, ischemia, and gangrenous perforation. Due to their propensity toward calamitous complications, they must be recognized and repaired as expeditiously as possible. Traditionally these hernias have been repaired by either an open transabdominal or an open transthoracic approach. Laparoscopic repair with Nissen fundoplication has already been successfully applied to the repair of the more common sliding hiatal hernia. Described here is the laparoscopic repair of two paraesophageal hernias. The merit of an anti-reflux procedure as part of this repair is discussed.
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PMID:Laparoscopic repair of incarcerated paraesophageal hernias. 799 58

We report the case of a patient with a large hiatal hernia accompanied by partial gastric volvulus in whom the computed tomography (CT) findings mimic the appearances of thrombus in the inferior vena cava (IVC). To our knowledge, this has not been previously reported as a cause of "pseudothrombosis" of the IVC on CT.
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PMID:Intrathoracic stomach. Another cause of IVC pseudothrombosis. 803 2

A massive incarcerated hiatal hernia is a frequent finding in elderly people. The aim of this report has been to review from 1987 to 1992 the clinical aspects, therapeutic options and results of surgical treatment in a series of twenty-eight patients (23 females and 5 males) with a large incarcerated hiatal hernia. Age averaged 66 +/- 10 years; thirteen patients (46.5%) had a sliding type of hernia, 8 (28.5%) a mixed one, and 7 (25%) a paraesophageal hernia. In 9 patients (32%) there was a chronic volvulus of the incarcerated stomach. Twenty-seven patients underwent elective repair; one patient developed a perforated gastric ulcer into the pericardial sac with pneumopericardium and died before surgery. The surgical technique included reduction of the hernia, closure of the hiatus and an antireflux procedure (Nissen 25, Toupet 1 and Dor 1). There was no mortality and the morbidity (18%) was not directly related to the surgical procedure. In our series there were no cases of acute volvulus requiring emergency surgery. Our results suggest that surgical correction of massively incarcerated hiatal hernias is well tolerated in the elderly, it relieves symptoms, and avoids potential serious complications.
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PMID:[Incarcerated giant hiatal hernia]. 812 90


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