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

During the last decade neonatal surgical results have improved considerably. Except for infants born with serious congenital heart disease, diaphragmatic hernia or exomphalos, postoperative mortality rates for infants with single anomalies have fallen to the region of 10%. This dramatic success story has been marred by a corresponding increase in the number of individuals with several anomalies entering late childhood with severe chronic handicaps. During the remainder of this century much effort will be expended in devising programmes of investigation which will attempt to predict which individuals will have a poor long-term prognosis. Such programmes will necessitate very close liaison between obstetricians, radiologists, neonatologists, local paediatricians, paediatric surgeons, general practitioners and parents. Very urgent surgery is necessary for the best results in infants with gastroschisis, intestinal volvulus and irreducible inguinal hernia, but for most other conditions there have been recent trends away from very urgent surgery to operation during daylight hours within the ensuing 24 h. Surgery within a few hours of presentation is necessary for intussusception and for early acute appendicitis, but perforated appendicitis should be treated by aggressive fluid replacement and intravenous antibiotics and surgery should be contemplated only in the rare cases of continued deterioration.
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PMID:Paediatric emergencies. 176 28

In a prospective evaluation of acute intestinal obstruction in emergency surgery, 3550 consecutive patients were studied. In the vast majority of patients (75%), obstruction was due to the external hernia, the inguinal hernia being by far the commonest type. However, the ascaris worm in children, volvulus of the sigmoid colon in adults, and intussusception in both children and adults, were significant causes of the disorder, and together accounted for 18% of the patients. Obstruction by the ascaris worm is easy to diagnose (by stool microscopy), and effective treatment (with antihelminthics) is readily available and cheap. A large number (90%) of the volvulus patients required resection for gangrene of the colon, thus arguing a strong case in support of laparotomy and inspection of the colon whenever feasible. A significant (41%) proportion of intussusception cases were adult, and in 33% of this group the lesion was associated with a tumour of the small bowel. The chief reason for death (10%) was late reporting to hospital.
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PMID:Tropical surgical abdominal emergencies: acute intestinal obstruction. 190 26

In recent years patients with cystic fibrosis (CF) have experienced longterm survival and have demonstrated a number of intra-abdominal complications. This report evaluates the intra-abdominal complications seen in 69 of 189 children with cystic fibrosis from 1972 to 1983. Forty-one patients were boys and twenty-eight girls. Complications occurred in 36 neonates, with meconium ileus (MI) noted in 33 and giant cystic meconium peritonitis (GCMP) in 3. Meconium ileus equivalent occurred in seven older children presenting with bowel obstruction. In addition, rectal prolapse occurred in 12, inguinal hernia in 10, intussusception in 3, cholelithiasis in 3, GE reflux in 4, stress ulcer in 1 and appendicitis in 1. Three infants with GCMP survived resection and enterostomy. Infants with MI were divided into simple (15) or complicated (18) cases. Nonoperative therapy using gastrografin enema was successful in three of eight with simple MI. Operative enterotomy and irrigation was successful in three cases while resection and enterostomy was done in nine. MI was complicated by atresia, volvulus and/or perforation in 18 cases requiring resection and anastomosis or enterostomy. Survival for MI was 86% compared to 36% in 25 MI patients treated in the previous two decades. Meconium ileus equivalent was successfully managed using gastrografin enema in five of seven children. Only 3 of 12 children with rectal prolapse required repair. Two cases of intussusception were reduced while one required resection. Three of 10 children had hernia recurrence due to chronic pulmonary problems.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intra-abdominal complications of cystic fibrosis. 404 71

Neonatal abdominal plain films were prospectively analyzed over a 41-month period in order to generate a differential diagnosis for focal bowel distension during the first 6 weeks of life. A total of 31 examples of locally distended bowel were collected. The study discredits the concept that asymmetrically distended bowel in the newborn is usually caused by necrotizing enterocolitis (only 9/31 cases) and indicates that distended bowel in the lower abdomen or left upper quadrant is often caused by air trapping in normal but redundant rectosigmoid (11 cases) or in distal transverse colon (three cases). Five other pathologic conditions not normally specified in differential diagnoses of focally distended bowel included inguinal hernia (three cases), small bowel atresia (two cases), midgut volvulus (one case), Hirschsprung's disease (one case), and small left colon (one case). The study emphasizes the value of sequential supine and prone filming for distinguishing normal from pathologic dilated loops of bowel.
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PMID:Localized bowel distension in the newborn: a review of the plain film analysis and differential diagnosis. 669 78

A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and other series. Because the most common cause of intestinal obstruction in Africa is strangulation, a preventable complication of inguinal hernia, the clinician has a unique opportunity to significantly decrease the incidence of intestinal obstruction in Africa. Finally, our study confirms that the single most important antecedent of a grave prognosis in intestinal obstruction is late presentation of the patient.
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PMID:Mechanical bowel obstruction. Review of 316 cases in Benin City. 736 10

In nine patients with meconium peritonitis prenatal ultrasonographic findings were correlated with the clinical course and outcome. Ultrasound findings included polyhydramnion (n = 4), ascites (n = 4), disseminated (n = 3) and solitary echogenic areas (n = 1), echopoor cystic areas (n = 3) and echogenic-echopoor solitary areas (n = 1). Intra-abdominal calcifications were found in five patients before delivery. Eight neonates survived and were subsequently followed up, one fetus died in utero. Four of the eight survivors required surgery, namely for meconium ileus (n = 1), perforation secondary to intestinal volvulus (n = 2) and inguinal hernia associated with prenatal rubella infection (n = 1). Three patients were healthy, one patient required drainage of pleural effusion and respirator therapy but recovered without further problems. Cystic fibrosis was diagnosed in the patient with meconium ileus. Postnatal outcome could not be predicted from the prenatal sonographic findings.
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PMID:[Meconium peritonitis: intrauterine follow-up--postnatal outcome]. 770 30

Small bowel obstruction, excluding postoperative adhesive ileus, in patients > 1 month old treated between June 1982 and May 1992 at Gunma Children's Hospital Medical Center is reviewed. There were 32 patients, 22 boys and 10 girls, whose ages ranged from 1 month to 6 years (median 9 months). Intussusception was the most frequent cause of obstruction and was seen in 17 patients (53.1%). Causative lesions were identified in five patients, and were ileal duplication cysts in four and Meckel's diverticulum in one. Incarcerated inguinal hernia and mesenteric cysts resulted in bowel obstruction in six and three patients, respectively. Other causes included mesodiverticular band, ileal volvulus without malrotation, abnormal adhesion of omentum, abnormal band, vitelline duct remnant and trapping in a mesenteric defect. As for the age distribution, there was no significant correlation between the causes of obstruction and the age of patients. Ultrasonography was useful in differential diagnosis, and this modality should therefore be used in every patient with signs of small bowel obstruction.
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PMID:Small bowel obstruction in children: review of 10 years experience. 810 28

Five hundred and fifty-two cases of intestinal obstruction were seen over a two year period, January 1987 to December 1988. Strangulated external hernias and adhesions still remain the most common causes of intestinal obstruction in Accra, but there has been a change in their relative incidence with external hernias falling to 59.8 per cent and adhesive obstruction increasing to 21.0 per cent. There has been no change in the overall mortality and mortality from inguinal hernia which are still 9.4 per cent and 4.9 per cent respectively. However, there has been a significant improvement in mortality rate from volvulus and a slight improvement in mortality from adhesive obstruction even though the overall resection rate has increased from 12.7 per cent to 17.6 per cent.
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PMID:Changing pattern of acute intestinal obstruction in Accra. 839 37

The pattern of intestinal obstruction at Khartoum Teaching Hospital was reviewed in this study which included 239 patients. 170 of them were males and 68 were females. Their ages ranged from two days to 95 years (mean 31.4 +/- 5.3 years). The commonest causes of intestinal obstruction were strangulated external hernias (27.7%), intestinal adhesions (21%), intussusception (12%) and sigmoid volvulus (11%). Less frequent causes were paralytic ileus, large bowel tumours, peritoneal bands and Hirschsprung's disease. Of the strangulated hernias, inguinal hernia (70%) was the most frequent type of hernia seen, followed by paraumbilical hernia (20%). Previous appendicectomy (40%) and laparotomy for abdominal trauma (20%) were the commonest causes of adhesive intestinal obstruction. The mortality rate of intestinal obstruction was 19.7%. This high mortality is attributed to delayed presentation, fluid and electrolyte imbalance, intestinal ischaemia and gangrene. This could be minimised by health education, adequate preoperative preparation, meticulous surgical technique and good postoperative care.
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PMID:Intestinal obstruction in Khartoum. 875 35

Colonic volvulus is a rare complication of celiac disease. A case is reported of a 46-year-old man with a long-standing history of diarrhea and abdominal distention with a diagnosis of irritable bowel syndrome. After an elective inguinal hernia repair, a cecal volvulus and an ulcerative jejunoileitis developed in the patient that required an extensive intestinal resection. Short bowel syndrome developed and was treated with total parenteral and enteral nutrition. The patient had a poor course after reinitiation of oral diet. Subsequently, celiac sprue was diagnosed and the patient improved with a gluten-free diet.
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PMID:Colonic volvulus and ulcerative jejunoileitis due to occult celiac sprue. 958 89


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