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

Sigmoid volvulus is an extremely rare cause of abdominal pain in children. More commonly seen in older adults, an SV occurs when a redundant loop of sigmoid wraps around its elongated, narrow mesentery causing obstruction and ischemia to the affected bowel segment. Children usually present with abdominal pain, nausea, and abdominal distension. Presentations may be acute or chronic with a history of episodic constipation or abdominal distension. The treatment plan includes an initial reduction of the volvulus via sigmoidoscopy with rectal biopsy to rule out Hirschsprung disease; however, operative management to remove the dilated sigmoid colon may be required in the setting of recurrence or confirmed Hirschsprung disease. Although rare, SV should be considered in a child presenting with abdominal pain as a missed diagnosis can have high potential morbidity and mortality.
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PMID:Pediatric Sigmoid Volvulus. 2959 83

We report a case of a 79-year-old gentleman who presented to the emergency department with a 5-day history of abdominal pain, constipation, a progressively distending abdomen and new onset feculent vomiting on a background of a recent endoscopic decompression of a sigmoid volvulus. Investigations confirmed the presence of a recurrent sigmoid volvulus. Attempts to reduce this endoscopically failed and laparotomy with sub-total colectomy and ileostomy formation was performed. Histology from the resected specimen identified a distinct pathology, namely intestinal lipofuscinosis also known as brown bowel syndrome. Brown bowel syndrome is a recognized but rare complication of chronic long term malnutrition. It may present in a myriad of ways including atonia and, rarely, massive colonic dilatation, as in our case.
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PMID:Brown bowel syndrome, an unusual cause of sigmoid volvulus. 2959 62

BACKGROUND Sigmoid volvulus (SV) is a life-threatening condition occasionally seen in adults. Adult Hirschsprung's disease (HD)-related SV is rarely complicated by difficult-to-control hypertension. In this report we present the case of an elderly man with a rare constellation of HD, SV, and refractory hypertension. CASE REPORT An 82-year-old man had long-term constipation, moderate abdominal pain, and progressive abdominal distension. A CT scan revealed the typical "coffee bean sign". Blood pressure was abnormal high. Subsequently, the patient's condition deteriorated. Therefore, he underwent a Hartmann's procedure. A giant and redundant sigmoid colon (length more than 60 cm, maximal diameter about 15 cm) was demonstrated to be the cause of SV during the process of surgery. Moreover, abdominal compartment syndrome caused by SV resulted in his high and refractory blood pressure (BP). Postoperative pathological results revealed HD in his sigmoid colon. CONCLUSIONS SV is rarely combined with conditions like refractory hypertension or HD among the elderly. Clinical features of SV typically present with long-term constipation, severe abdominal pain, and progressive abdominal distension. The "coffee bean sign" could be observed in imaging examinations. It is important to note that the management of SV is to relieve the obstruction and prevent recurrence, no matter which therapy is used in elderly patients with Hirschsprung's disease.
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PMID:Hirschsprung's Disease-Related Giant Sigmoid Volvulus Complicated by Refractory Hypertension in an Elderly Man. 2967 6

Cases of colonic volvulus in children are infrequently described in the literature. Here we describe the case of three patients with colonic volvulus. The first patient was a 10-year-old girl with abdominal dilation and pain and no bowel movement for 48 h. Her abdominal X-ray showed the coffee bean sign adjacent to the diaphragm, which was compatible with a diagnosis of cecal volvulus. The second patient was a 4-year-old boy with a history of chronic constipation during the past year and with no bowel movement for 24 h. Clinical manifestations included severe nausea, vomiting, and abdominal distension. His abdominal X-ray demonstrated the coffee bean sign in the right upper quadrant with upward convexity corresponding to a diagnosis of sigmoid volvulus. The third patient was a 10-month-old male who presented with excessive crying, malnutrition, and no bowel movement for 36 h. His abdominal X-ray demonstrated the coffee bean sign in the left upper quadrant with upward convexity. The presence of gas was not observed in the distal obstructed region, corresponding to a diagnosis of sigmoid volvulus. All three patients successfully underwent colonoscopy for volvulus reduction. Volvulus did not reoccur in any of the patients within 6 months of follow-up. It is recommended to perform abdominal X-ray imaging in patients who present with abdominal pain and distension, diarrhea, or constipation for possibly diagnosing volvulus.
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PMID:Colonoscopic decompression of childhood sigmoid and cecal volvulus. 2974 31

Cecal bascule is a unique form of large bowel volvulus in which the cecum folds anterior to the ascending colon and generates a flap valve which impairs cecal emptying and results in cecal dilation [1]. Presenting symptoms include nausea, vomiting, abdominal pain, distension, and constipation. We report a case of a 74-year-old male who developed abdominal pain and nausea after a coronary artery bypass graft surgery. Imaging demonstrated an enlarged cecum measuring up to 17.7 cm as well as upstream small bowel dilation. The patient underwent nasogastric tube and endoscopic decompression, relieving his cecal dilation and symptoms.
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PMID:Cecal bascule as a cause of postoperative nausea and abdominal pain. 3097 71

Lymphangioma is a benign malformation of the lymphatic system. It usually affects the neck, head, and rarely, the abdomen. Volvulus is a serious condition, which occurs as a result of bowel twisting around itself or around the mesentery leading to severe consequences such as obstruction. The most common cause of volvulus in children is malrotation. We report a rare case of a 2-year-old boy who was brought by his parents to the emergency room with the complaint of constipation for 5 days and vomiting for the last 4 days. Examination and plain abdominal X-ray suggested intestinal obstruction. Furthermore, ultrasonography indicated the presence of a cyst and dilatation of the bowel. On exploratory laparotomy, an ileal volvulus caused by cystic lymphangioma developed on the mesenteric wall and associated with ileal and jejunal dilatation was observed. The diseased segments were resected in addition to 5cm before and after the cystic lymphangioma to prevent recurrence.
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PMID:Ileal volvulus secondary to cystic lymphangioma: A rare case report with a literature review. 3114 2

Dolichocolon has been described as a developmental variant and is characterized by redundancy of the colon. Diagnosis is based off clinical symptoms and barium enema or CT-colonography. This redundancy is often seen in the adult and elderly population, with pediatric prevalence limited to case reports. Information regarding radiologic evaluation is limited, as most cases are documented outside of the radiology literature. This case report demonstrates a complex course of transient symptoms of constipation, obstruction, and suspected volvulus in a 1-month-old with dolichocolon. A retrospective review of the images offers insight into gaining suspicion of this variant in radiographs and fluoroscopic exams.
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PMID:Redundant: A case of complicated dolichocolon in a neonate. 3136 Feb 79

Megacolon is a congenital disorder. Adult congenital megacolon (ACM), also known as adult Hirschsprung's disease, is rare and frequently manifests as constipation. ACM is caused by the absence of ganglion cells in the submucosa or myenteric plexus of the bowel. Most patients undergo treatment of megacolon at a young age, but certain patients cannot be treated until they develop bowel obstruction in adulthood. Bowel obstruction in adults always occurs in complex clinical situations and it is frequently combined with comorbidities, including bowel tumors, volvulus, hernias, hypertension or diabetes mellitus. Surgical intervention is always required in such cases. To avoid recurrence, a sufficient amount of bowel should be removed, particularly the aganglionic segment. Furthermore, the patient's general physical condition should be considered pre-operatively by controlling parameters including blood pressure and blood glucose. In the present study, a case of ACM combined with fecal impaction and diabetic nephropathy was presented.
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PMID:Adult congenital megacolon with acute fecal obstruction and diabetic nephropathy: A case report. 3157 19

Caecal volvulus has been reported to be associated with various abdominal and pelvic pathologies. Its signs and symptoms are usually non-specific and maybe overlooked in favour of benign causes, such as constipation. A high degree of suspicion is required for prompt diagnosis. Herein, we report on an unusual case of caecal volvulus after a dental procedure that was managed initially as constipation.
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PMID:Caecal Volvulus after a dental procedure - not just constipation! 3182 34

Ischemic colitis (IC) associates with older age, hypertension, and heart disease, among others. Young-onset IC is rare. We aimed to delineate clinical characteristics of young patients (<40 years) with IC. Cases from 1984 to 2017 were re-reviewed. Of the 60 cases available, 52% (n = 31) had histologic features of IC. Fifty-five percent were female with a mean age of 32 (range = 14-40) years. Fifty-eight percent (n = 18) were resections. The most common presentations were diarrhea and abdominal pain. Three teenagers had IC associated with prior surgery, volvulus, and constipation. In the 21- to 40-year group, 43% (n = 12) lacked clinical associations. A second subset (n = 6, 21%) had histories of immune dysregulation (lupus, dermatomyositis, vasculitis) and poorly controlled HIV/AIDS (n = 5, 18%). Smoking and cocaine were endorsed by 1 and 2 patients, respectively. One patient had premature atherosclerosis while another had HMG Co-A lyase deficiency. Vasculitis was identified in 22% of the resections and in none of the biopsies. Nineteen percent of patients died (n = 6) from complications of IC, all treated surgically, including 1 patient previously misdiagnosed as ulcerative colitis; 2 patients died of unrelated causes. While rare before 20 years of age, IC in teenagers relates to mechanical issues and is rare in children. Associations in young adults include immune dysregulation, cocaine and cigarette use, and premature atherosclerosis. Our retrospective cohort had a surgical mortality rate within the range reported by others, highlighting the importance of accurate diagnosis in young individuals.
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PMID:Young-Onset Ischemic Colitis: A Condition of Elusive Etiology Frequently Associated With Immune Dysregulation. 3187 Feb 9


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