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

Sixty-six patients who had a jejunoileal bypass with ileosigmoidostomy for intractable obesity were reviewed. Thirty-three patients had sudden, severe, upper pain develop in the abdomen with distention from one to four years after the original operation. All 33 patients had a repeat laparotomy from one to six years after the initial bypass procedure. In every instance, a dilated, hypertrophied defunctioned ileum was found proximal to the ileosigmoidostomy. In 11 patients, an ileosigmoid volvulus was present. In every instance, the ileosigmoid anastomosis was dismantled and an end-to-side ileotransversostomy performed. In one patient, an ileal volvulus developed proximal to the ileotransversostomy because of an inadvertent technicality and this was corrected by reoperation. The remaining 32 patients have been asymptomatic since the ileosigmoidostomy was converted to ileotransversostomy. To date, in more than 200 primary operations for morbid obesity, the ileum has been drained into the transverse colon. None of these patients have had obstruction of the defunctioned small bowel develop.
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PMID:Jejunoileal bypass and the defunctioned bowel syndrome. 45 6

In a consecutive series of 40 Scott-type jejunoileal shunts for morbid obesity, only two patients had the bypassed bowel drained end-to-side into the midsigmoid colon. In both of these patients, typical "bypass enteritis" as described by Passaro developed, but they were found to have volvulus at the sigmoid anastomosis. Both were cured by take-down of the anastomosis and reimplantation of the bypassed bowel into the transverse colon. No antibiotic treatment was found necessary. We suspect that obstruction of a mechanical nature plays a basic role in most, if not all, cases of "bypassed enteritis."
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PMID:Bypass enteritis or obstructive volvulus? 85 70

A case of small-bowel volvulus occurring during pregnancy after pancreaticobiliary bypass for morbid obesity is presented. The association between pregnancy, previous small-bowel bypass surgery and intestinal volvulus is discussed.
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PMID:Small-bowel obstruction in pregnancy after Scopinaro weight reduction operation. A case report. 334 Sep 18

Complications associated with jejunoileal bypass for morbid obesity are being recognized more frequently. A variety of mechanical obstructions in the defunctionalized small-bowel segment have recently been corrected in seven surgical patients. Volvulus of the defunctional limb was the most frequent cause of obstruction. Intussusception, bypass enteritis, fascial hernia, and adhesive bands were also causes of obstruction. Radiographic contrast studies were valuable in establishing the preoperative diagnosis. The altered small-intestinal anatomy predisposed these patients to a uniquely subtle and dangerous form of closed-loop obstruction. Prompt recognition was based on patient history and physical findings. Characteristic roentgenographic findings often confirmed the diagnosis. Clinical suspicision of these small-bowel obstructive syndromes may lead to early surgical treatment.
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PMID:Obstruction of defunctionalized small bowel: its occurrence after bypass surgery for morbid obesity. 741 49

During the past 9 years, 393 Roux-en-Y gastric bypass operations for morbid obesity were performed by one surgeon at a university hospital. Twelve of the 393 patients subsequently developed mechanical small-bowel obstruction, and 7 of these 12 cases developed in the initial 38 patients in this series. There were 2 cases of small-bowel volvulus and 10 cases of postoperative adhesions. Three cases of adhesive obstruction occurred at the jejunojejunostomy. Two of the patients with anastomotic obstruction required operative treatment, whereas the remaining patient was successfully treated by nasogastric tube decompression. A simple technique is described that has successfully prevented this type of anastomotic obstruction in 355 subsequent Roux-en-Y gastric bypass operations. This technique should be useful in preventing anastomotic obstruction after any stapled end-to-side enteroenterostomy.
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PMID:The antiobstruction stitch in stapled Roux-en-Y enteroenterostomy. 787 43

Obstruction of the small intestine is a recognized complication after Roux-en-Y gastric bypass surgery for morbid obesity. Reported causes after bariatric surgery include volvulus, adhesion, internal hernia, hemorrhagic bezoar, incarcerated ventral hernia, and intussusception. Intussusception after Roux-en-Y gastric bypass for morbid obesity is rare. The etiology remains largely obscure. A delay in the diagnosis and management may result in catastrophic outcomes. Management should include the early involvement of a bariatric surgeon. We describe the clinical and radiologic presentation of a case of jejunojejunal intussusception 4 years after open Roux-en-Y gastric bypass.
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PMID:Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication. 1692 87

Intestinal malrotation is usually encountered in infants. Its main complication is midgut volvulus, a situation that presents itself with bilious vomiting. This symptom allows for early surgical treatment. A delay in diagnosis and treatment may lead to catastrophic sequelae, such as extensive bowel necrosis and death. This situation is rare but well known in adults. Laparoscopic gastric banding is a popular option for treating morbid obesity. One of the consequences of this procedure may be impaired vomiting when there is an obstruction below the band. In this paper, we present a case in which a patient suffered from midgut volvulus 4 years after a laparoscopic gastric banding. Owing to impaired vomiting, the diagnosis was delayed, therefore, severely endangering the patient. This case prompted us to suggest that malrotation should be actively sought after before or during any bariatric procedure.
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PMID:Midgut volvulus following laparoscopic gastric banding--a rare and dangerous situation. 1757 Jul 79

Surgery is an increasingly important management option for patients with obesity. Laparoscopic adjustable gastric banding is a procedure employed to treat morbid obesity refractory to medical therapy. It works by reducing the capacity of the stomach and promoting early satiety. We report the unusual case of a 33-year-old female who presented acutely 2 years following laparoscopic adjustable gastric banding with cecal volvulus and closed loop obstruction caused by displacement of the connecting tube.
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PMID:Cecal volvulus as a complication of gastric banding. 1883 Jul 81

Internal hernias are a specific cause of acute abdominal pain and are a well-known complication after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Although internal hernias are a rare cause of intestinal obstruction, they may evolve towards serious complications, such as extensive bowel ischemia and gangrene, with the need for bowel resection and sometimes for a challenging reconstruction of intestinal continuity. The antecolic position of the Roux limb is associated with a decrease in the incidence of small-bowel obstruction and internal hernias. The best prevention of the formation of these hernias is probably by closure of potential mesenteric defects at the initial operation with a non-absorbable running suture. We present a patient in late pregnancy with a small-bowel volvulus following laparoscopic Roux-en-Y gastric bypass for morbid obesity and discuss the available literature. For a favorable obstetric and neonatal outcome, it is crucial not to delay surgical exploration and an emergency operation usually is mandatory.
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PMID:Small-bowel volvulus in late pregnancy due to internal hernia after laparoscopic Roux-en-Y gastric bypass. 1918 55

Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for the treatment of morbid obesity. LAGB complications have declined since its development in the early 1990s. However, LAGB complications are still occurring and can sometimes be serious and life threatening. These complications are related either to the band or to the access port, such as band slippage or tubing disconnection, retrospectively. We report a rare case of bowel obstruction due to caecal volvulus caused by connecting tube used in LAP-BAND system in a bariatric operation, which obstructed a caecal loop, in a female who had undergone LAGB 2 years previously. Diagnosis of bowel obstruction was established with plain abdominal radiograph appearances. Follow-up abdominal computed tomography findings confirmed the diagnosis of caecal obstruction and revealed the underlying cause for this obstruction. Surgery was performed, and intraoperative examination demonstrated that connecting tube of the LAP-BAND system was a main causative factor. We can hypothesize that bowel obstruction secondary to LAGB operation may become frequently diagnosed as more LAGB operations performed worldwide. The emergence of many problems, such as this, can be minimized with enhancement in the development of better surgical materials, proper operative technique, and close postoperative management and follow-up.
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PMID:A serious but rare complication of laparoscopic adjustable gastric banding: bowel obstruction due to caecal volvulus. 1943 83


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