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

Intestinal volvulus may be the underlying process in patients presenting with intestinal ischemia. In 3 patients, angiographic findings of volvulus were erroneously interpreted as indicating occlusive or nonocclusive intestinal ischemia. In a fourth, the correct preoperative diagnosis was suggested by angiographic findings. Volvulus should be suspected at angiography by the whirlpool arrangement of the mesenteric arterial branches, the delayed filling and emptying of the arteries, and the intense opacification of the bowel wall. Familiarity with the angiographic picture of intestinal volvulus is essential for early diagnosis and for prompt initiation of appropriate therapy.
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PMID:Intestinal volvulus: angiographic findings. 67 22

Etiologic and physiopathologic aspects of volvulus of the sigmoid colon in Brazil are presented. It is believed that sigmoidal volvulus in Brazil is a frequent complication of megacolon caused by Chagas' disease, differing in some characteristics from volvulus found in other countries. A review of 230 cases treated between 1938 and 1974 in the Surgical Department of Hospital das Clinicas, University of Sao Paulo School of Medicine, is presented. The successive variations used to treat this disease occurred parallel to those introduced in the surgical treatment of uncomplicated megacolon. From the results, the following treatment is recommended: endoscopic emptying in cases without clinical, roentgenographic or endoscopic signs of intestinal ischemia. Laparotomy should be performed when a complicated volvulus is suspected or when it is not possible to empty the loop. When a simple volvulus is found, the loop should be untwisted and the gaseous contents siphoned off by menas of a rectal catheter. When there is necrosis of the colon, the Hartmann operation is recommended. It is important to submit patients to a definitive treatment of the megacolon soon after endoscopic emptying or surgical detorsion of the volvulus, since recurrences following these measures are frequent.
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PMID:Volvulus of the sigmoid colon in Brazil: a report of 230 cases. 81 36

Intramural gas collection in a bowel segment is an important roentgenological sign, consistent with necrosis of the bowel wall. This is demonstrated by an example of jejunal volvulus and an inflammatory conglomeration of intestine. The diagnostic interpretation must be completed by the clinical picture and other signs of intestinal ischemia.
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PMID:[Intramural gas collection in the small bowel (author's transl)]. 118 92

The case of a neonate with midgut volvulus and severe intestinal ischemia extending from the ligament of Treitz to the midtransverse colon is presented. Management consisted of abdominal silo application at the initial exploration to obviate the adverse physiological consequences of increased intraabdominal pressure from reperfusion edema of the intestine. The majority of the intestine was salvaged, and a short segment of ileum was resected. This method of treatment resulted in optimal ventilatory status, renal function, and cardiac performance. The advantages of temporary prosthetic wound coverage in selected cases of midgut volvulus include greater physiologic stability through the avoidance of "intraabdominal hypertension" and the ability to monitor the status of the intestine at the bedside.
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PMID:Management of catastrophic neonatal midgut volvulus with a silo and second-look laparotomy. 140 16

Computed tomographic examinations of two cases of small-bowel volvulus were reviewed. At laparotomy, both cases were proved to be secondary to adhesions. CT examinations showed focal, wedge-shaped, edematous mesentery with trapped fluid between mesenteric folds radiating toward the site of torsion. One case showed the superior mesenteric vein spiraling around the superior mesenteric artery. At laparotomy, affected small-bowel loops showed ischemia in both cases. CT performed in patients with acute abdomen may show findings suggestive of small-bowel volvulus.
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PMID:Computed tomographic findings of small-bowel volvulus. 141 May 66

Small bowel volvulus is an uncommon but important cause of small intestinal obstruction. It often results in ischemia or even infarction. Delay in diagnosis and surgical intervention increases morbidity and mortality rates. Based on cause, small bowel volvulus can be divided into primary and secondary type. Goals for treatment of small bowel volvulus should include physician awareness of this uncommon diagnosis, accurate workup, and advanced surgical intervention. The presentation and subsequent management of 35 patients with small bowel volvulus confirmed by laparotomy are reviewed and discussed. The incidence of small bowel volvulus in the adult European and North American is low. The resultant mortality rate, however, makes diagnosis critically important. The cardinal presenting symptom is abdominal pain. There is no single specific diagnostic clinical sign or abnormality in laboratory or radiologic finding. In practice, the diagnosis can only be made by laparotomy. The failure to perform an exploratory laparotomy cannot be justified. Early diagnosis and early surgery are the keys for successful management of strangulation obstruction of the small bowel.
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PMID:Acute small bowel volvulus in adults. A sporadic form of strangulating intestinal obstruction. 150 17

This elderly male with a long history of alcohol abuse presented with an acute pleural trauma and hemopneumothorax, which may have served as the precipitating medical illness for cecal volvulus. He subsequently developed bacterial peritonitis as a complication of his bowel obstruction. It is probable that his pleural cavity was seeded hematogenously via a bacteremia from his peritonitis, thus accounting for the empyema with species typical of bowel flora. Cecal bascule is a type of cecal volvulus that causes intestinal obstruction. Diagnosis is difficult, but a delay in recognition may result in intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined based on physical examination or laboratory findings. Plain films of the abdomen may be helpful, and barium enema has been advocated by some authors. However, laparotomy is often necessary for definitive diagnosis and therapy. While cecal volvulus has not been reported to occur frequently in the elderly, the relatively common occurrence of anatomic predisposition in addition to the widespread use of respirators and the increasing age and number of medical illnesses of our population make it possible that cecal volvulus will be seen with increasing frequency in the future.
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PMID:Cecal bascule: an overlooked diagnosis in the elderly. 172 51

Acute abdomen was the presenting manifestation of pseudomembranous colitis in six men who had previously been treated with antibiotics and presented with abdominal distention, pain, fever, and leukocytosis with absent or mild diarrhea. Plain abdominal radiographs revealed megacolon in two, combined small and large bowel dilation in three, with one of them showing volvuluslike pattern, and isolated small bowel ileus in one. Emergency colonoscopy was performed successfully in all patients and revealed pseudomembranes in five and nonspecific colitis in one. All patients had positive latex test results for Clostridium difficile, and two tested positive for cytotoxicity. All patients were treated with IV metronidazole, resulting in resolution of symptoms and abdominal findings. In addition, two patients underwent colonoscopic decompression with improvement. Endoscopically, complete resolution of the pseudomembranes occurred at 4 weeks in all cases. No patient had a recurrence. It is concluded that (a) pseudomembranous colitis may present as abdominal distention mimicking small bowel ileus. Ogilvie's syndrome, volvulus, or ischemia; (b) in such cases, emergency colonoscopy is safe and useful for diagnosis and therapeutic decompression and may obviate the need for surgery; and (c) treatment with IV metronidazole is effective. Colitis due to C. difficile should be considered in the differential diagnosis of acute abdomen in patients previously treated with antibiotics.
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PMID:Acute abdomen as the first presentation of pseudomembranous colitis. 161 51

Acute gastric volvulus in children is uncommon. Since 1899, only 77 cases have been documented in the world literature. In children, mesenteroaxial volvulus is the most common type and associated anatomic defects are the rule. Diagnostic delays result in gastric ischemia, perforation, and death. Nonoperative mortality is 80%. Early recognition, surgical reduction with gastric fixation, and repair of associated defects are the mainstays of therapy for acute gastric volvulus in the pediatric population.
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PMID:Gastric volvulus in the pediatric population. 192 47

Small-bowel volvulus is an uncommon but important cause of small-bowel obstruction and often results in ischemia or infarction. Clinical examination and plain film radiography may be nondiagnostic, leading to delay in surgical intervention with subsequent increase in morbidity and mortality. We present two patients in whom the diagnosis of strangulating small-bowel volvulus was made by computed tomography (CT), allowing rapid surgical correction of this potentially life-threatening condition.
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PMID:CT diagnosis of acquired small bowel volvulus. 222 14


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