Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042961 (volvulus)
 4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 75-year-old black man came to the emergency room because of nausea, vomiting, abdominal pain, and distension and obstipation. An abdominal radiograph revealed a sigmoid volvulus. This was nonoperatively reduced in the emergency room. Following a mechanical and antibiotic bowel preparation, the patient underwent elective exploration. We report, for the first time, operative treatment of sigmoid volvulus with a laparoscopic-assisted sigmoid colectomy and primary anastomosis. Because of dense fibrous scarring of the sigmoid mesentery produced by chronic mesosigmoiditis, the redundant sigmoid was exteriorized and resected extracorporeally. A stapled, side-to-side, functional end-to-end anastomosis was constructed. The patient experienced little postoperative pain and virtually no postoperative ileus. We believe that laparoscopic-assisted sigmoid resection may offer distinct advantages for the treatment of the typically elderly, debilitated patient in whom sigmoid volvulus develops. Furthermore, because of the characteristic mesosigmoiditis associated with sigmoid volvulus, we suspect that exteriorization and extracorporeal resection may prove the easiest and most rapid laparoscopic approach to this disease.
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PMID:Laparoscopic-assisted sigmoid colectomy for sigmoid volvulus. 134 64

Abdominal lymphangiomas are usually classified together with mesenteric cysts. However, they differ by location, histology, and potential for recurrence, and should be considered a separate clinical entity. Thirteen children, aged 2 weeks to 11 years (mean, 5.8 years), with abdominal lymphangiomas were identified over the past 16 years at this institution. Of these, 12 were symptomatic. Abdominal pain (11), vomiting (8), increased abdominal girth (8), and nausea (6) predominated. Other presentations were less frequent. Symptoms were present for an average of 2 months (7 less than 1 week) before correct diagnosis. An abdominal mass was palpable in 10 cases. Intestinal gangrene secondary to volvulus was present in 2. Although multiple imaging modalities were used ultrasonography (8/8) and computed tomography (CT; 4/4) proved most expedient and reliable. In 2 cases, the lymphangioma could not be completely resected. There was 1 recurrence. Although intraabdominal cystic lesions are described in the literature as relatively symptom-free, our experience suggests otherwise. In this series, abdominal pain and an abdominal mass were common. Catastrophic complications can occur and excision is facilitated by earlier diagnosis and the benefit of smaller size. Ultrasound and CT can accurately diagnose the lesion and should be used liberally in children with intermittent or ill-defined abdominal pain, leading to prompt recognition and definitive treatment.
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PMID:Pediatric abdominal lymphangiomas: a plea for early recognition. 181 64

The increased use of child safety seats and seat belt restraints has significantly reduced the incidence of severe head injuries associated with motor vehicular accidents. However, an increase in the number of both acutely recognized intestinal perforations and delayed obstructions due to ischemic strictures has been noted. This report describes two children with delayed onset of intestinal obstruction related to the "seat belt syndrome" who presented with bilious emesis 3 to 6 weeks following an unrecognized lap belt injury. At laparotomy, a volvulus around an omental band adherent to a resolving traumatic mesenteric hematoma was the basis of the obstruction in both cases. The volvulus resulted in a stricture in each instance that required resection and end-to-end anastomosis. The diagnosis of posttraumatic intestinal obstruction should be suspected in children who develop nausea and bilious emesis following motor vehicular accidents in which they were wearing lap belts.
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PMID:Delayed onset of intestinal obstruction in children after unrecognized seat belt injury. 221 49

Cecal volvulus after cesarean section is rare. Symptoms include abdominal pain, nausea, vomiting, constipation, cystic abdominal mass, and high-pitched bowel sounds. Abdominal x-ray photography is often diagnostic, revealing a dilated cecum with a single fluid level and distended loops of small bowel. The main differentiating factors in post-cesarean large bowel distention are sigmoid volvulus and pseudo-obstruction of the colon. Treatment should accomplish derotation, decompression, and anchoring to prevent recurrence.
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PMID:Post-cesarean section cecal volvulus. 336 3

Antimonial preparations (Pentostam, Neostibosan, stibophen, and tartar emetic) have occasionally been used in the treatment of onchocerciasis without very promising results. The advent of the preparations TWSb (stibocaptate) and MSbE (Friedheim) of allegedly reduced toxicity made it desirable to test them against Onchocerca volvulus.The action of both preparations on the parasites was found to vary from one patient to another, ranging from complete elimination of all parasites in a few cases to no detectable action in others. A microfilaricidal action was detectable in many patients, particularly after treatment with TWSb, which was used at higher doses than MSbE. A lethal or sterilizing action on some or all adult female worms was observed in some patients. However, toxic reactions to the drugs were common and distressing, and often it was necessary to stop treatment on this account. Anorexia, nausea, vomiting and prostration were the most common manifestations, and there was one fatality from coincident yellow fever, which may well have been aggravated by antimony treatment.The uncertain action of these preparations on O. volvulus and the toxic manifestations that accompany their use render them unsuitable for the treatment of onchocerciasis, and it is probable that the effects of antimony on O. volvulus are produced only at or above the normal level of human tolerance.
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PMID:The effects of drugs on Onchocerca volvulus. 2. The antimonial preparations TWSb and MSbE. 488 Oct 67

Idiopathic gastric volvulus is not rare, especially in the neonate and in infancy. Between 1966 and 1980 we managed 44 cases of gastric volvulus. In 22 of the cases, initial examination was performed under 1 year of age. The main symptoms in this group were vomiting and abdominal distention, while those in the group over 2 years of age were abdominal distention, weight loss, nausea, appetite loss etc. The upper G.I. series were the most important in diagnosis. There was only one case of acute volvulus, which was treated operatively on an emergency basis. Chronic volvulus could be treated conservatively, except in 2 cases. This consisted in the positioning of the patient in the upright right recumbent position after feeding, for at least 1 hour. In the supine position, the gastric fundus is filled and dilated when the milk is poured into the stomach, the fundus is pulled postero-caudally and the antrum is pulled upwards, resulting in the combined type of organo-axial and mesenterico-axial volvulus. Over 2 years of age, 77% required operation. The fixation of the gastric fornix with the diaphragm was performed, using 5 or 6 stitches. The result was quite satisfactory. We recommend this procedure in this operation.
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PMID:Idiopathic gastric volvulus in infancy and childhood. 728 54

An 83-year-old woman, largely bedridden since a stroke 2 years before, was hospitalized because of upper abdominal pain, nausea and obstipation. She had regularly been taking laxatives of the anthraquinone type. She had a fever of 38.6 degrees C and leukocytosis (14,900/microliters). Radiological examination revealed volvulus of the sigmoid colon with ileus. As she vehemently refused an operation, it was attempted to reduce the volvulus endoscopically. At the first coloscopy the volvulus was untwisted. At that time there were already areas of necrosis in the rectosigmoid and descending sigmoid portions. As the volvulus recurred three days later, another coloscopic derotation was performed, this time with fixation of the sigmoid by three gastrostomy tubes for 20 days. The further course was uncomplicated, the patient had regular bowel movements and became free of fever and symptoms. The white cell count returned to normal and the intestinal mucosa healed histologically without scarring. There has been no recurrence for 10 months. The conventional treatment of volvulus of the sigmoid is decompression followed by sigmoid resection. This case describes for the first time the nonoperative treatment by percutaneous endoscopic colopexy.
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PMID:[Percutaneous endoscopic colopexy--a new treatment possibility for volvulus of the sigmoid]. 771 43

A prospective study of 200 consecutive open emergency appendicectomies was carried out. All patients were informed before operation that they would be discharged the following day if possible. The operation was performed through a standard muscle-splitting incision. At the end of the operation the wound was infiltrated with bupivacaine and a diclofenac suppository was given. There were 29 normal, 129 acutely inflamed, six gangrenous and 36 perforated appendices. In all, 147 patients (73.5 per cent) were discharged home within 24 h and reviewed 2 weeks later. Twelve patients had seen their general practitioner, mainly for wound problems (eight) or pain (two). Two others required readmission. Thirty-four patients (23.1 per cent) required no postoperative analgesia; 104 (70.7 per cent) required paracetamol or co-proxamol for < or = 3 days and nine (6.1 per cent) for > 3 days. No patient had a problem directly related to early discharge from hospital. Fifty-three patients (26.5 per cent) were not discharged home early due to peritonitis (36), social reasons (seven), nausea (seven), associated caecal volvulus (one) and pregnancy (two). Early discharge from hospital within 24 h after emergency appendicectomy is safe and has good patient acceptability.
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PMID:Early discharge from hospital after open appendicectomy. 840 30

During pregnancy, intestinal obstruction due to sigmoid volvulus is extremely rare. Only 73 cases have been reported. A 24-year-old black woman, gravida 2, para 1, presented during Week 36 of an otherwise uneventful pregnancy, with intermittent abdominal pain and constipation, and no history of nausea, vomiting, fever, chills, previous medical problems, or prior abdominal surgery. Her previous pregnancy was a spontaneous vaginal delivery of a normal full-term neonate. On examination, she was afebrile, with abdominal tenderness. Laboratory studies revealed elevated WBC count of 13,500. She was admitted and given a Fleet enema, with no result or change in abdominal pain. Pain worsened; reexamination of her cervix revealed 3 cm dilation. After Pitocin augmentation, a viable male infant with Apgars of 7 and 9 was delivered. Postpartum, abdominal pain continued, with worsening abdominal distention. Radiograph revealed a massively distended colon. Physical examination 12 hours postdelivery indicated peritonitis. Exploratory laparotomy revealed volvulated, gangernous, massively distended sigmoid colon. The sigmoid colon was resected and Hartmann's colostomy performed. She was discharged on postoperative Day 4. Sigmoid volvulus complicating pregnancy is an uncommon and potentially devastating development that should be suspected with worsening abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity.
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PMID:Sigmoid volvulus in pregnancy. 861 67

A 35-year-old female who had previously undergone an open gastric bypass, underwent elective caesarian section and ventral hernia repair, complicated by a double closed-loop obstruction with resulting gastric perforation. Back pain and anemetic nausea predominated, as proximal bowel and pancreatobiliary obstruction followed an afferent limb volvulus. Pancreatitis, cholangitis, and gastric perforation ensued, leading to intraabdominal sepsis. This rare situation must be recognized as a potentially serious complication of gastric bypass surgery, and requires prompt recognition and aggressive surgical correction.
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PMID:Afferent limb volvulus and perforation of the bypassed stomach as a complication of Roux-en-Y gastric bypass. 1284 11


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