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

During an 18-month period, gastric dilatation was recognized in six guinea pigs from a colony with a monthly average of 253 animals. All of the affected guinea pigs were breeders and ranged in age from 8 to 26 months. Clinical signs were tachycardia, dyspnea, cyanosis, and marked abdominal distention. Macroscopic lesions included gastric volvulus, gastric dilatation, and splenic congestion.
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PMID:Acute gastric dilatation associated with gastric volvulus in the guinea pig. 59 85

Between 1960 and 1980, 53 patients with massive incarcerated hiatal hernia were treated surgically. In 24 of the 53 patients, there was an associated organoaxial volvulus. The following symptoms and signs, which are almost peculiar to massive, incarcerated hernias, were observed: postprandial precordial distress in 43 patients, upper gastrointestinal bleeding (manifest or occult) in 24 patients, severe dyspnea in 13 patients, and complete obstruction associated with organoaxial volvulus in 4. In only 1 of the 53 patients was the hernia of the true paraesophageal type with the esophagogastric junction remaining in its normal, intraabdominal location. The remainder were all believed to be advanced stages of an ordinary sliding hiatal hernia. Operative treatment consisted of gastroplasty and partial fundoplication in 36 patients, standard Belsey repair in 14, and transabdominal Nissen repair in 3. Gastroplasty and partial fundoplication were used much more frequently during the 1970s, when it was realized that there is a significant incidence of chronic peptic esophagitis and shortening in these patients. Postoperative complications were few in spite of the advanced age of many of the patients. There was one operative death. Only 1 patient was lost to follow-up, and of the 51 patients remaining for analysis, follow-up has extended from 1 to 16 years, with a mean of 6.2 years. No patient has developed recurrent precordial pain, evidence of upper gastrointestinal bleeding, iron deficiency anemia, or severe dyspnea. Seven patients have residual dysphagia; this condition is minimal in 5, and is significant in 2 who require interval esophageal dilation. Nine patients have symptomatic reflux, which is minimal in 5 patients, moderate in 2 patients, and severe in 2 others who were subsequently reoperated on. Contrary to popular concept, our observations indicate that almost all of these patients represent advanced degrees of sliding hiatal hernia with intrathoracic displacement of the esophagogastric junction. This implies a need for an adequate antireflux reconstruction in all patients undergoing operation, as well as an awareness that unanticipated cicatricial changes may be present in the distal esophagus and may prejudice the success of some of the standard hiatal repairs.
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PMID:Massive hiatal hernia with incarceration: a report of 53 cases. 660 Mar 88

A baby boy had had transhiatal gastric transposition for wide gap esophageal atresia in another hospital. Postoperatively, repeated vomiting, chest infection, and frequent attacks of dyspnea developed. After reexploration, the cause was not identified and he was referred to the authors' institution. The diagnosis of iatrogenic organoaxial volvulus with gastric outlet obstruction was made because barium meal studies and nuclear isotope scanning showed persistent obstruction of the gastric outlet but upper endoscopy showed no stenosis and a flexible scope could be passed easily into the duodenum. The diagnosis was confirmed by thoracotomy. After full mobilization of the stomach, the gastroesophageal anastomosis was divided and the thoracotomy was closed. The stomach was reduced into the abdomen via laparotomy, and it was tubularized and rerouted retrosternally for anastomosis to the cervical esophagus. Since the operation the patient has been asymptomatic.
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PMID:Iatrogenic gastric volvulus during transposition for esophageal atresia: diagnosis and treatment. 893 47

Twenty-seven patients underwent consecutive elective laparoscopic repair of paraesophageal hiatal hernia between October 1992 and June 1997. There were 24 females and 3 males. The average age was 68 years (range, 46-86) and average weight was 173 pounds (range, 122-243 lb.). Presenting symptoms were: postprandial epigastric pain or pressure in 19 patients, postprandial dyspnea in 7 patients, anemia in 5 patients, postprandial vomiting of food in 5 patients, and 1 patient had postprandial palpitation. Heartburn was present in 9 patients. Five patients had a history of symptoms of intermittent volvulus. History of hiatal hernia was present in 19 patients ranging from 6 months to 38 years in duration. The operative procedure included a laparoscopic reduction of the herniated stomach, excision of the hernia sac, and closure of the diaphragmatic defect with placement of mesh graft. Anterior gastropexy was performed on all patients except two who had a Nissen fundoplication due to severe reflux symptoms. Seven patients had laparoscopic cholecystectomy at the same time and one patient had an excision of a small benign gastric leiomyoma of the fundus. The average operative time was 2:54 hours (range, 1:35-4:05 hrs.). The average hospital stay was 3.8 days (range, 2-8 days). One patient had a postoperative stroke and recovered quickly. Follow-up of 1 to 56 months showed no recurrence of the hernia. Two patients complained of some epigastric pain and six patients had occasional mild reflux that was easily controlled medically. Laparoscopic repair of paraesophageal hernia is a safe procedure with a short hospital stay and recovery time. Using mesh graft decreases the risk of developing an iatrogenic parahiatal hernia. The addition of Nissen fundoplication is not necessary unless the patient has objective findings of reflux.
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PMID:Laparoscopic repair of paraesophageal hiatal hernia. 969 97

Gastric dilatation-volvulus (GDV) is a disease in which there is gross distension of the stomach with fluid or gas and gastric malpositioning. It causes pathology of multiple organ systems and is rapidly fatal. It is common in large- and giant-breed dogs. The disease appears to have a familial predisposition. Thoracic depth/width ratio also appears to predispose dogs to GDV. Implicated dietary factors include dietary particle size, frequency of feeding, speed of eating, aerophagia and an elevated feed bowl. A fearful temperament and stressful events may also predispose dogs to GDV. Abdominal distension, non-productive retching, restlessness, signs of shock, tachypnoea and dyspnoea are possible clinical signs. Initial treatment includes treatment of shock and gastric decompression. Surgical treatment should be performed promptly. There are no studies comparing the use of different anaesthetic agents in the anaesthetic management of GDV. Pre-medication with an opioid/benzodiazepine combination has been recommended. Induction agents that cause minimal cardiovascular changes such as opioids, neuroactive steroidal agents and etomidate are recommended. Anaesthesia should be maintained with an inhalational agent. Surgical therapy involves decompression, correction of gastric malpositioning, debridement of necrotic tissue, and gastropexy. Options for gastropexy include incisional, tube, circumcostal, belt-loop, incorporating, and laparoscopic gastropexy. Expected mortality with surgical therapy is 15-24%. Prognostic factors include mental status on presentation, presence of gastric necrosis, presence of cardiac arrhythmia and plasma lactate levels. Prophylactic gastropexy should be considered in dogs identified as being at high risk.
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PMID:Gastric dilatation-volvulus in dogs. 1603 41

Three cats were examined because of acute dyspnoea and sudden abdominal enlargement. In all cats, radiographs revealed gastric dilatation-volvulus (GDV) and diaphragmatic hernia. Cardiovascular shock and dyspnoea were treated by intravenous fluid-therapy, oxygen administration and relief of diaphragmatic pressure by means of stomach decompression and in one case placing the patient in an inclined position. Gastric decompression was performed by needle gastrocentesis, placement of a rhino-gastric tube, or a combination of these. Diaphragmatic herniorrhaphy was performed in either case; one cat also underwent gastropexy. The immediate postoperative period resolved uneventfully and the cats were doing well at follow-up. Feline GDV is a rare event in which diaphragmatic hernia may be a predisposing factor.
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PMID:Gastric dilatation-volvulus associated with diaphragmatic hernia in three cats: clinical presentation, surgical treatment and presumptive aetiology. 1808 38

The advantages of minimally invasive therapy can be utilised in the surgical disorders of pregnant patients. To our knowledge, there has not been a previous report describing laparoscopic management of diaphragmatic hernia (with mesh) in pregnancy. A 23-year-old pregnant (second trimester) woman was admitted with vomiting, epigastric pain, oliguria and dyspnoea of one month duration. Investigations revealed posterolateral diaphragmatic hernia of Bochdalek with gastric volvulus. Successful laparoscopic mesh-plasty of the diaphragmatic hernia was performed without mortality or morbidity to both mother and child. Principles of laparoscopic surgery for diaphragmatic hernias remain the same. Pregnancy poses challenges to both surgeon and anaesthetist due to changes in the physiology. Acute diseases that threaten the life of mother and child have to be dealt with urgently. We conclude that even complex laparoscopic surgery during pregnancy is feasible.
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PMID:Laparoscopic mesh repair of a Bochdalek diaphragmatic hernia with acute gastric volvulus in a pregnant patient. 1820 56

The hiatus hernia and sigmoid volvulus are usually found in older patients. The delay of the treatment of both of these illnesses may result in increased morbidity and mortality. We report a case of an isolated intrathoracic hiatal herniation of the twisted sigmoid colon. The patient complained about cramping abdominal pain, vomiting, and dyspnea. Chest X-ray and CT scan of the thorax showed a distended colonic segment in the posterior mediastinum. The patient underwent cruroplasty, Nissen fundoplication, and sigmoid colon resection. This is the first report of such a rare case.
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PMID:Isolated intrathoracic hiatal herniation of the twisted sigmoid colon: report of a case. 1940 83

The gastric volvulus is a not very frequent entity that can show up in acute form or chronic. The acute volvulus can show up with the triad of Borchardt, the chronic one can be asymptomatic and its diagnosis is usually incidental. We present shows a case of an airplane pilot that presents dyspnea to the medium efforts with cough related with episodes of gastric acidity mainly after profuse foods. The diagnostic confirmation was carried out by means of radiological simple and contrasted studies. A surgical intervention was performed and the symptoms disappeared without other alterations in a period of pursuit of one year.
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PMID:[The gastric volvulus as a cause of dyspnea. A case report]. 2680 91

Acute gastric volvulus is a rare condition complicating 4% of hiatus hernias. It is a more or less complete rotation of the stomach around a transverse or longitudinal axis. It can lead to perforations due to ischemic gastric wall necrosis with very poor prognosis (30% of mortality). We here report the case of an 89-year old female patient with chronic bronchopathy, presenting with epigastralgias associated with vomiting which had progressed for 03 days. Physical examination showed febrile patient at 38.5 with dyspnea (SpO2 88% at room air). Her appearence suggested infection, the abdomen was soft, tender at the level of the epigastrium. Laboratory test showed SBI (WBCs= 22000, CRP= 80). Abdominal CT scan showed hiatus hernia associated with significant gastric distension with wall defect in the anterior face of the stomach associated with pneumatosis in the gastric wall. The patient underwent surgery using a median approach, which showed voluminous hiatus hernia containing the greater curvature of the stomach. Distended stomach was restored to its normal intra-abdominal position. The anterior face of the greater tuberosity was the seat of several areas of necrosis. Total gastrectomy with manual oesojejunal anastomosis associated with Roux-en-Y gastric bypass was performed. The postoperative course was complicated by acute respiratory distress syndrome (ARDS). The patient died on day 8 after emergency hospital admission. Gastric volvulus is a rare condition, which can lead to extremely severe consequences. CT scan allows for thoracic lesion assessment and to study stomach vitality. The treatment of choice is based on surgery.
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PMID:[Gastric necrosis secondary to gastric volvulus complicating hiatus hernia]. 3277 9


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