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

Laparoscopic Nissen fundoplication was first performed in 1991. With the increasing number of these procedures being performed it is appropriate to review the published short-term results. A retrospective review of reports on this subject was performed. There were a total of 2453 patients available for review. Twenty-five of 2453 (1.0%) patients had an esophageal or gastric perforation and 28 of 2453 (1.1%) patients required transfusion for bleeding. Forty-nine of 2453 (2%) patients developed a pneumothorax. Two of 2453 (0.1%) patients required a splenectomy. Conversion to the open procedure was necessary in 5.8% (143 of 2453) of patients. The laparoscopic approach is associated with minimal postoperative morbidity. Four of 2453 (0.2%) needed further early surgery for persistent bleeding, 11 of 2453 (0.4%) for a missed perforation, 22 of 2453 (0.9%) for crural disruption, paraesophageal herniation, or gastric volvulus. Four of 2453 (0.2%) patients died of either a missed duodenal perforation, a missed esophageal perforation, ischemic bowel with mesenteric thrombosis, or myocardial infarction. Early postoperative dysphagia occurred in 500 of 2453 (20.3%) patients. Late postoperative dysphagia occurred in 114 of 2068 (5.5%), with the need for dilatation in 72 of 2068 (3.5%). Endoscopy was required for food impaction in 11 of 2068 (0.5%) and re-operation for dysphagia occurred in 18 of 2068 (0.9%). Fifty-seven of 1658 (3.4%) patients developed reflux symptoms and 11 of 1658 (0.7%) required revisional surgery. Satisfaction rates ranged from 87 to 100%. In the short term, laparoscopic fundoplication can be performed with less morbidity and mortality than the open procedure. It is superior to medical therapy. Long-term follow-up is awaited.
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PMID:Laparoscopic Nissen fundoplication: where do we stand? 911 40

We reviewed the clinical records of the 1st 144 consecutive patients in whom the Probe trade mark, a balloon-on-the-wire, was used for percutaneous transluminal coronary angioplasty at the Texas Heart Institute. The goal of our retrospective study was to establish the efficacy and safety of this new balloon catheter. The Probe was used in 227 lesions, most of which were considered severe and difficult to pass. The Probe was the 1st catheter used in 160 lesions (70%), and in 67 lesions (30%) the Probe was used after other balloon catheters. In 70.9% (161/227) of lesions treated, the Probe reduced the stenosis to less than 50% of the luminal diameter. Of 144 patients treated, 116 (81%) had a successful result: 98 of these had adequate recanalization of all vessels treated, while 17 had adequate recanalization of the most significant vessels. A relatively high number of lesions (17 lesions, 7.5%) became totally occluded during the procedure. Eight patients (6%) required emergency surgery because of impending infarction. No hospital deaths occurred, and there were only 2 patients who suffered transmural myocardial infarction. Of the 160 Probe devices used, 23 (14%) malfunctioned: the balloon ruptured in 11 procedures; the balloon twisted, causing "balloon volvulus," in 5; the balloon failed to deflate in 4; and the tip detached in 3. The Probe has significant advantages over other balloon systems for treating severe coronary lesions because of its low profile, but it is also less reliable and safe. Our results show that the Probe should be used with great care, and only in treating lesions not amenable to treatment with removable-guidewire catheters.
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PMID:The probe, a balloon-on-the-wire: clinical experience with a new low-profile, fixed-wire balloon catheter system. 1522 11

Reversal of a Hartmann's operation can be a morbid undertaking; successful restoration of intestinal continuity cannot be guaranteed. Between June 2001 and July 2006, 35 Hartmann's reversals were undertaken. There were 19 males (54%). Mean age was 54.7 years (range, 14-82 years). Twenty-one (60%) patients had their Hartmann's for diverticular disease, 7 (20%) for anorectal cancer, 4 (11%) for volvulus, and 3 for miscellaneous reasons. Mean length of stay was 7.7 days (range, 3-16 days); 23 per cent required intensive care for a mean 2.3 days (range, 1-4 days). Blood loss was 470 mL, and mean operative time was 4.28 hours (range, 1-8.3 hours). The mean time interval between the original operation and its reversal was 8.9 months (range, 1.4-55 months). Extensive lysis of adhesions was required in 69 per cent, 40 per cent experienced minor complications (urinary tract infections, ileus, and so on), and 38 per cent had major complications (myocardial infarction, leak, hernias, respiratory failure). There was one death (3%). The operation failed because of intraoperative circumstances in three patients (8%). Ten patients (26%) had stomas at the time of discharge of which 3 were intended to be permanent and 7 were temporary. Of the latter, 3 were successfully closed, 3 are awaiting closure, and 1 had complete anastomotic failure requiring permanent diversion. Total failure rate was 10.3 per cent; contributing factors included prior radiation and ultra-low anastomoses.
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PMID:Hartmann's colostomy reversal: outcome of patients undergoing surgery with the intention of eliminating fecal diversion. 1767 37

Usually CPK, CK-MB and lactate dehydrogenase (LDH) enzymes are measured in blood during the period of myocardial infarction. The changes in LDH assay indicates duration of the infarction.The level of lactate dehydrogenase is 500 times greater in tissue than those found in serum. A small mass of damaged tissue causes leakage of enzyme and increases its level in serum.Any cause of tissue break down/hemolysis which is sufficiently severe can produce LDH pattern similar to that in myocardial infarction.We report this case of small bowel volvulus showing significant increase in LDH.It may be due to tissue necrosis which increases the level of LDH in serum.
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PMID:Raised Serum Lactate Dehydrogenase associated with gangrenous small bowel volvulus: A case report. 2310 85