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

Hepatodiaphragmatic interposition of the intestine is a rare anomaly (0.025 to 0.28 percent of the general population) described by Chilaiditi in 1911 and often believed to be of irrelevant clinical interest. To the contrary, recent studies stated that this syndrome is a potential source of abdominal problems requiring emergency or elective operation. From a retrospective analysis of records since 1976, four instances of Chilaiditi's syndrome have been found (three males and one female). Interposition of the proximal transverse colon was found in three patients and the small intestine in one patient. The findings of plain roentgenograms of the chest were determinants for diagnosis in three patients. In one patient, a barium meal was given to obtain a better definition. Two patients were admitted for malignant neoplasms (metastatic carcinoma of the breast, carcinoma of the gastrointestinal tract and cirrhosis of the liver) and died within a few months. The other two patients complained of abdominal pain. Patient No. 4 had gastric volvulus. Chilaiditi's syndrome was diagnosed intraoperatively in that patient and a surgical treatment with hepatopexy was performed, by suturing the falciform, the coronaria ligament and the anterior margin of the liver to the diaphragm with interrupted absorbable stitches. After a two year follow-up evaluation, this patient is as well as the patient who underwent medical therapy. Volvulus of the stomach, as was found in Patient No. 4, is an unusual condition and, to our knowledge, the patient is the second reported instance.
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PMID:Chilaiditi's syndrome as a surgical and nonsurgical problem. 842 5

Cystic fibrosis (CF), the most common lethal autosomal recessive disease in white populations, is characterized by dysfunctional chloride ion transport across epithelial surfaces. Although recurrent pulmonary infections and pulmonary insufficiency are the principal causes of morbidity and death, gastrointestinal symptoms commonly precede the pulmonary findings and may suggest the diagnosis in infants and young children. The protean gastrointestinal manifestations of CF result primarily from abnormally viscous luminal secretions within hollow viscera and the ducts of solid organs. Bowel obstruction may be present at birth due to meconium ileus or meconium plug syndrome. Complications of meconium ileus include volvulus, small bowel atresia, perforation, and meconium peritonitis with abdominal calcifications. Older children with CF may present with bowel obstruction due to distal intestinal obstruction syndrome or colonic stricture, and tenacious intestinal residue may serve as a lead point for intussusception or cause recurrent rectal prolapse. Radiologic studies often demonstrate thickened intestinal mucosal folds in older children and uncommonly show colonic pneumatosis, peptic esophageal stricture due to gastroesophageal reflux, and duodenal ulcer. Appendicitis due to inspissated secretions is uncommon. Obstruction of ducts and ductules produces exocrine pancreatic insufficiency, pancreatitis, cholestasis, cholelithiasis, and cirrhosis with portal hypertension. On imaging studies, the pancreas is commonly small and largely replaced by fat, sometimes displays calcifications, and is rarely replaced by macrocysts. Radiologic features of hepatobiliary disease include an enlarged radiolucent liver from steatosis, gallstones, a shrunken nodular liver, splenomegaly, and portosystemic collateral vessels. With the improved survival of CF patients, an increased risk for developing gastrointestinal carcinomas has been established, many occurring as early as the 3rd decade.
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PMID:Gastrointestinal manifestations of cystic fibrosis: radiologic-pathologic correlation. 883 77