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

A mechanical ileus was considered in the differential diagnosis of a 28-year-old man who presented to the Emergency Clinic with acute, severe, painful cramps in the lower abdomen of 2 hours' duration, without radiation and with an urge to move constantly. An emergency laparotomy was then performed, revealing non-rotation of the intestine; the last segment ofthe small intestine was pinched off by a strangulation. Several strangulations were cleaved, after which the symptoms disappeared. Non-rotation, a form of malrotation, is a congenital anomaly of intestinal rotation. In adults, non-rotation is a rare diagnosis with a variable presentation. Surgical intervention is necessary in both the acute and the more chronic presentation. The chronic presentation is usually discovered by chance in patients who have had aspecific recurrent abdominal complaints for a long time; if malrotation is suspected, additional investigation, for example by means of a gastrointestinal contrast study, is necessary before resorting to surgery. In the acute situation, immediate surgery is the only proper decision. Surgical intervention comprises reduction of the volvulus, inspection of the mesenteric bands (Ladd's bands) that run from the coecum to the lateral peritoneum and compress the duodenum, and an appendectomy: the Ladd procedure.
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PMID:[An adult with mechanical ileus in association with non-rotation of the intestine]. 1590 95

The case of a 73-year-old male patient come to the Emergency Department for epigastric pain, vomiting and blocked bowel movement is presented. Plain abdominal X-ray performed on emergency showed marked small bowel distention, and air-fluid levels suggestive of intestinal obstruction. CT was indicated to establish its precise site and cause. The presence of a gallstone was evidenced: gallstone ileus was diagnosed. Interestingly enough, at surgery the gallstone was not found; most likely it was expelled spontaneuously during the time elapsed between CT and surgery. Based on imaging findings and a review of the literature it was concluded that the study patient had a rare association of intestinal volvulus and gallstone ileus.
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PMID:Reasoned diagnostic approach to a case of small bowel obstruction. 1602 24

From 1998 to 2002, 369 patients (47.39% M, 52.61% F; mean age 67.9 yrs) were faced in the Authors' Department due to acute intestinal obstruction. The main reasons of obstruction were adhesions in 281 patients (76.15%), followed by malignant neoplasms of large intestine in 41 patients (11.11%) hernias in 9 patients (2.44%), Ischemic colitis (4.1%), bezoars (2.39%), bile stone (2.71%) and volvulus (1.1%). In this study the clinical and laboratorial investigation, the preoperative preparation and the applied surgical treatment of patients with obstructive ileus are discussed. Also it is stressed the importance of the proper preoperative support, as well as the convenient surgical confrontation of patients.
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PMID:A causal factors and treatment of obstructive ileus in 369 patients. 1669 23

Intestinal obstruction may be mechanical or non-mechanical (adynamic ileus). Adhesions and external hernias are the most common causes of obstruction in small intestine, whereas carcinoma, sigmoid diverticulitis, and volvulus are the most common causes in large intestine obstruction. Distension of the intestine caused by gas and fluid accumulation in the obstructed segment is the key pathophysiological mechanism initiating ileus with subsequent multiorgan failure and death. Surgery should always be undertaken if complete obstruction or strangulation is suggested and ileus is established. Before operation, the fluid and electrolyte balance should be restored and decompression instituted by means of a nasogastric tube. Delaying the operation because of improvement in patient well-being during resuscitation is only justified in those suffering from large intestine obstruction due to colorectal carcinoma. Purely nonoperative treatment is safe only in the presence of incomplete obstruction and best utilized in patients with postoperative adynamic ileus or repeated episodes of partial obstruction.
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PMID:[Ileus disease]. 1696 60

Extensive resection (50-75%) of the large colon was performed in 12 horses. Indications for resection were: loss of viability due to large colon volvulus (seven), thromboembolic episode (three), impairment of flow of ingesta due to adhesions (one), or congenital abnormalities (one). The time required to correct the primary cause of abdominal pain and complete the resection ranged from 2.5 to 4.75 hours. Three horses had severe musculoskeletal problems postoperatively and were euthanized in the recovery stall. Four other horses were euthanized early in the postoperative period because of: further large colon infarction (two), ileus (one), or small intestinal problems (one). Five horses survived with no apparent nutritional or metabolic problems during two to three weeks of hospitalization. Clinical data were obtained from these horses from nine months to eighteen months postoperatively and revealed no clinical or clinicopathological abnormalities in four of them; the fifth horse exhibited diarrhea and weight loss four months postoperatively but responded to diet change.
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PMID:Extension large colon resection in 12 horses. 1742 68

The omasums of 30 healthy cows and 55 cows with various gastrointestinal disorders (10 with left displacement and eight with right displacement of the abomasum, 10 with abomasal volvulus, 10 with traumatic reticuloperitonitis, nine with ileus of the small intestines and eight with reticulo-omasal stenosis) were examined ultrasonographically on the right side of the body with a 3.5 MHz linear transducer. The dorsal and ventral margins of the omasum and its size in the fifth to 11th intercostal spaces were determined. Generally, the ultrasonographic appearance of the omasum did not differ between the healthy and abnormal cows. The omasum appeared as a semicircle, and the omasal wall closest to the transducer was visible as a thick echogenic line. In a few of the abnormal cows, the omasal laminae were visible and the omasum appeared to have motility. In the cows with left and right displacement of the abomasum and abomasal volvulus, the dorsal margin of the omasum was significantly further from the dorsal midline in some intercostal spaces than in the healthy cows. In the cows with left displacement of the abomasum, the ventral margin of the omasum was significantly further from the dorsal midline in the 7th intercostal space than in the healthy cows. In the cows with reticulo-omasal stenosis, traumatic reticuloperitonitis and ileus of the small intestine, the ventral margin of the omasum was significantly closer to the dorsal midline in some intercostal spaces than in the healthy cows. The mean (sd) size of the omasum in the healthy cows varied from 16.3 (1.5) cm to 56.9 (10.0) cm, depending on the intercostal space, and the omasum was significantly smaller in some intercostal spaces in the cows with reticulo-omasal stenosis, right displacement of the omasum, abomasal volvulus and ileus of the small intestine.
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PMID:Ultrasonography of the omasum in cows with various gastrointestinal diseases. 1758 90

Primary volvulus means idiopathic volvulus without predisposing factor and is rare in children. The etiology is unknown. The incidence is relatively higher in neonates. The most common symptoms are abdominal distension and bilious vomiting. Our patient was a preterm baby at age of 89 days. Acute onset of abdominal distension and sepsis-like symptoms were noted. After operation, no anatomical anomaly was noted. Probable primary midgut volvulus was diagnosed. Early diagnosis of primary volvulus of the small intestine is difficult. Operation should be performed as soon as possible in a neonate with quick progression toward unstable hemodynamics and acidosis with ileus. Postoperative short bowel syndrome was noted. There are often sepsis, enterocolitis, and poor body weight gain noted among short bowel patients. With breast milk feeding and probiotics usage, there were few complications of short bowel syndrome noted in our patient. The duration for establishing intestinal adaptation was shorter than for other patients. The patient's body weight, body length and development caught up gradually within 18 months.
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PMID:Possible effect of probiotics and breast milk in short bowel syndrome: report of one case. 1762 9

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

Primary small bowel volvulus in adults is a very rare condition, and it is defined as torsion of all or a large segment of the small intestine and its mesentery in the absence of any preexisting etiologic factors. Proper management of the patients suffering from a strangulated obstruction depends on making an early and accurate diagnosis. Timely treatment is crucial to prevent gangrene. A 49-year-old man who had a history of previous abdominal surgery was admitted to our hospital with complaints of acute abdominal pain. Simple abdominal x-ray showed multiple dilated loops of small intestine in the mid-abdomen. Enhanced abdominal computed tomography showed the distended small bowel loops and longitudinal tapering of the collapsed bowel loops. We carried out diagnostic laparoscopy to confirm the cause of suspected mechanical ileus. It revealed strangulation of the small bowel at the terminal ileum due to clockwise torsion of the bowel loop. There were no adhesions or congenital anomalies in the peritoneal cavity. The torsional segment was spontaneously reduced with minimal handling, and the strangulated portion was resected. The patient was discharged from hospital on postoperative day 6. Primary small bowel volvulus in adults is a very rare malady; if the diagnosis is uncertain, then diagnostic laparoscopy is a valuable tool for making the definitive diagnosis and administering prompt treatment.
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PMID:Laparoscopic management of a primary small bowel volvulus: a case report. 1771 63

Aerophagia, characterized by symptoms related to repetitive swallowing of air, is a functional gastrointestinal disorder. In some cases, severe aerophagia causes massive bowel distention and leads to volvulus, ileus, and even intestinal necrosis and perforation. A 10-year-old intellectually disabled boy was referred to our unit due to severe abdominal distention, bilious vomiting, no passage of feces and flatus during the previous 3 days. He had experienced episodes of severe abdominal distention and flatulence over the past 2-3 years. In the exploratory laparotomy, two old colonic perforations were found. Splenic flexura resection and diverting colostomy were performed. Rectal biopsy showed ganglionic architecture. During the fifth postoperative month, he was admitted to the emergency unit with severe abdominal distention. During this visit, we observed him swallowing air. For this reason, his primary illness was diagnosed as a pathologic aerophagia. The colostomy was closed 11 months following the first operation. His parents did not accept gastrostomy as a desufflator. For this reason, they were taught nasogastric tube installation for gastric distention. Briefly, if abdominal distention increases during the course of the day and increased flatus is observed during sleep, aerophagia could be the primary pathology. If aerophagia could cause complications, gastrostomy should be applied. If the parents refuse gastrostomy, the parents could perform nasogastric tube drainage.
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PMID:Colon perforation due to pathologic aerophagia in an intellectually disabled child. 1785 58


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