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

To determine the morbidity and mortality of Meckel's diverticulum (MD) as a cause of acute abdominal disorders and to evaluate the relationship between patient age, MD complications, and postoperative complications. We reviewed 74 patients who underwent surgery between 1990 and 2000 for an acute abdominal syndrome with a MD diagnosed intraoperatively. Forty children were treated before 1995 and reviewed retrospectively, while the remaining 34 were reviewed prospectively. The average age was 4.8 years; the male/female ratio was 2.5/1; 34 (46%) were less than 2 years old, 32 were between 2 and 8 years, and 8 were older than 8 years. None of the symptoms was suggestive of the diagnosis of MD. Thirty-nine MDs were asymptomatic (21 intussusception, 18 volvulus), but all were the secondary cause of the acute abdomen. The remaining 35 children had a symptomatic MD (diverticulitis in 14, diverticular bleeding in 11, diverticular perforation in 10). The risk of complications due to a MD occurring in children under 2 years and between 2 and 8 years of age was significantly higher compared to children older than 8 years (P = 0.02). Postoperative complications occurred more commonly in children between 2 and 8 years of age compared to other patients. There is thus an increased risk of morbidity in a symptomatic MD in patients less than 2 and between 2 and 8 years of age, and there is no predictive factor for the development of diverticular complications. Resection of the MD is recommended in all children younger than 8 years, including asymptomatic ones, in the absence of absolute contraindications.
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PMID:When to resect and when not to resect an asymptomatic Meckel's diverticulum: an ongoing challenge. 1272 25

Surgical emergencies can be missed easily in children, who are not always able to volunteer relevant information. Awareness of the entities discussed in this review might help the EP uncover subtle clues to early diagnoses that might not be initially apparent. Ill-appearing children who have abdominal pain and vomiting should be considered to have ischemic or necrotic bowel until proven otherwise. Possible diagnoses include volvulus, intussusception, and necrotizing enterocolitis. Bilious vomiting, especially in a young infant, should be considered to be an indication of a high bowel obstruction such as midgut volvulus, which warrants immediate surgical consultation. Significant rectal bleeding with abdominal pain can result from intussusception, volvulus, or an inflamed Meckel's diverticulum. Rectal bleeding with unstable vital signs can result from an upper GI bleed (eg, peptic ulcer disease). Painless rectal bleeding can result from a Meckel's diverticulum, polyps, arteriovenous malformation, or a tumor. Examination of the genitalia is imperative, especially in boys, to exclude the possibility of an incarcerated hernia or testicular torsion.
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PMID:Abdominal surgical emergencies in infants and young children. 1470 13

Meckel's diverticulum occurs in 2% of the population. Of these, 4% may present as intestinal bleeding, intussusception, diverticulitis, volvulus, or perforation at any age, including neonates. We describe a 3-month-old baby whose giant Meckel's diverticulum had probably perforated in utero, leading to the formation of a large intra-abdominal pseudocyst.
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PMID:Abdominal cystic mass in infancy--in utero perforated Meckel's diverticulum? 1545 27

A recent case of a Meckel's diverticulum diagnosed and successfully laparoscopically treated, triggered off a retrospective study on a series of 34 cases with Meckel's diverticulum admitted to the First Surgical Clinic between 1990-2003. We encountered 12 uncomplicated cases and 22 cases with a large panel of complications: 11 intestinal obstructions (volvulus 9, intussusceptions on a tumor-2), 9 cases with diverticulitis, 1 gastrointestinal bleeding and 1 case with Littre's inguinal hernia. Positive diagnosis was established intraoperatively and the surgical treatment was adapted according to the local situation (excision of the diverticulum or enterectomy). Out of 12 patients with uncomplicated Meckel's diverticulum 8 were subjected to prophylactic excision of the diverticulum. In 6 of these microscopic examinations were inclusions of gastric mucosa. Laparoscopy is safe, relatively inexpensive and efficient in the diagnosis and treatment of Meckel's diverticulum.
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PMID:[Meckel's diverticulum in laparoscopic era]. 1556 May 58

A 2-year-old boy presented at the emergency room with a surgical abdomen and respiratory and circulatory insufficiency caused by a volvulus of the short bowel around a string from a Meckel's diverticulum.
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PMID:[Diagnostic image (245). A 2-year-old boy with an acute abdomen]. 1612 82

We report a case of a Meckel diverticulum connected with the umbilicus through a fibrotic cord causing small bowel obstruction. On admission, the patient presented with an acute abdomen. A plain upright radiography of the abdomen, an ultrasonography of the abdomen, and an enema with gastrografin were performed, showing a small bowel obstruction at the level of the pre-terminal ileum, without revealing the cause. Urgent surgery followed, showing a persistent omphalomesenteric duct connected to the abdominal wall through a fibrotic cord, with a secondary volvulus of the small bowel. The remnant was resected and the volvulus reduced. The post-operative course was uneventful. Because of the serious complications and even possible mortality due to ischemic disease of the affected small bowel the possibility of a complicated persistent omphalomesenteric duct should be kept in mind, even if the preoperative work-up does not reveal a Meckel diverticulum.
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PMID:Small bowel obstruction due to a persistent omphalomesenteric duct. 1617 73

A wide variety of anomalies may occur as a result of the vitelline duct (VD) failing to obliterate completely. Most reports on symptomatic VD focus on Meckel's diverticulum, while other anomalies are given little attention. A retrospective review was conducted at our institution. According to the records 18 symptomatic children with VD anomalies were seen over 22 years, including 10 boys and 8 girls aged 11 days -14 years (median 7.5 months). Twelve patients aged below 10 years (median 28 days) had patent vitelline ducts (PVDs), 3 children aged 13 months, 13 years and 14 years respectively had Meckel's diverticulum (MD), presenting as inflammation, tapeworm incarceration and volvulus respectively. Two patients, both 8 years old, had umbilical sinus, and a 3-year-old had a vitelline cyst. Only 1 patient with PVD had an associated anomaly (intestinal malrotation). The diagnosis of PVD was obvious clinically, but in 1 patient the fistula was demonstrated by fistulogram. The diagnosis of MD was intraoperative in all 3 patients. Treatment was by various types of resection for PVD and MD and excision for umbilical sinuses and cysts. One patient with PVD developed postoperative intestinal obstruction from adhesions, requiring re-laparotomy and adhesiolysis. Two patients with PVD died from sepsis and anaesthetic-related complications, respectively. Although MD is the most commonly VD anomaly, PVD is the most common symptomatic presentation in our environment.
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PMID:Symptomatic vitelline duct anomalies in children. 1618 Mar 93

Meckel's diverticulum is a congenital diverticulum of the small intestine. Complications include perforation, inflammation, bleeding, obstruction, and volvulus. Resection of asymptomatic Meckel's diverticula [corrected] has been recommended; however, indications are not well defined. To delineate indications to resect asymptomatic Meckel's diverticulum, the charts of 16 men and 13 women, mean age 55.1 +/- 23 years, confirmed at surgery with Meckel's diverticula [corrected] were retrospectively reviewed. Two groups were identified: symptomatic resected (9); asymptomatic (20), which included resected (10) or not resected (10). The age ranges, male:female (M:F) ratios, the height:diameter ratios, heterotopic tissue, surgical management, and complications were recorded and compared. The average age for symptomatic resection was 34.9 +/- 23.2 years compared with 64.2 +/- 16.5 years for asymptomatic patients (P = 0.0006). Of patients under 50 years of age, 70 per cent (7/10) were symptomatic compared with 10 per cent (2/19) of those over 50 years of age. Overall, the M:F ratios between the groups were similar, and the average M:F ratio was 1.23:1. Surgical management of resected Meckel's diverticula [corrected] included 10 segmental resections and 10 diverticulectomies; one of each was laparoscopic. There were no differences in the complication rate, nor in outcomes between the groups. Heterotopic tissue was only identified in symptomatic patients, 33 per cent (3/9) versus 0 per cent (0/10) in resected asymptomatic patients. The height:diameter ratios were similar between the groups. Adult patients with symptomatic Meckel's diverticula [corrected] were more likely to be under the age of 50 and to have heterotrophic tissue. Resection of asymptomatic Meckel's diverticulum should be considered in patients under 50 years of age; patients over age 50 years of age will be less likely to benefit from prophylactic resection.
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PMID:High incidence of symptomatic Meckel's diverticulum in patients less than fifty years of age: an indication for resection. 1737 85

A 17 years old patient, admitted and operated in emergency with acute diffuse peritonitis which had been had the onset four days before. During surgery, a huge volvulus of the small intestine is revealed due to an adherence between Meckel's diverticulum and mesentery, with large intestinal necrosis. Extended enterectomy is performed with jejunostomy. The postoperative outcome is difficult due to severe metabolic insufficiencies which are managed by intensive therapy measures. The patient is readmitted to surgery and an anastomosis between 30 cm jejunum and 20 cm ileum is performed. Then the outcome is good, with digestive function recovery and weight gain. Unfortunately, the patient died one year after surgery, due to severe haematological and neurological disorders caused by the mal-absorbtion syndrome.
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PMID:[Short bowel syndrome due to a severe complication related to Meckel's diverticulum]. 1796 46

Intestinal malrotation is a developmental anomaly affecting the position and peritoneal attachments of the small and large bowels during organogenesis in foetal life. It has been defined as absent or incomplete rotation and fixation of the embryonic gut around the superior mesenteric artery. In the present paper, we review the definition, history, embryology/aetiology, epidemiology, symptoms and signs, diagnosis and treatment of intestinal malformations. Moreover, we report the records of 30 cases of malrotation admitted to our department over a period of five years. The final intraoperative diagnosis of the cases presented was 53.3% pure malrotation, 33.3% malrotation with mid-gut volvulus, 6.7% malrotation with duodenal atresia, 3.3% malrotation with Meckel's diverticulum and duodenal atresia, and 3.3% malrotation and biliary atresia. Preoperative imaging studies were performed for 27 cases and surgical management was successfully conducted without any mortality among the cases studied. This article provides an overview of basic and clinical aspects of intestinal malrotation. In addition, the signs and symptoms, imaging findings, and final intraoperative diagnoses presented by the subjects reported on are of potential use and clinical interest.
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PMID:Intestinal malrotations: a review and report of thirty cases. 1805 48


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