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

The case records of 12 patients with cecal volvulus over a 20-year period were reviewed. The patients averaged 46.7 years old; 75 per cent were white and 67 per cent were male. Patients presented with signs and symptoms of intestinal obstruction. Pain and distention were present in more than half of the patients. X-rays assisted in making the diagnosis of cecal volvulus in only five of the patients. Diagnosis was made in the remainder at the time of surgical exploration. At operation, one cecum was necrotic and required resection. Five patients underwent cecostomy, two cecopexy, and four simple detorsion. Post-operatively, one patient developed a wound infection. There were no deaths. Follow-up for seven patients averaged 75 months each. One patient who had undergone simple detorsion developed another cecal volvulus. All who were contacted were alive and well. At St. Luke's Hospital, cecal volvulus generally occurs in middle-aged white males. Cecostomy or cecopexy adequately treats cecal volvulus when the cecum remains viable. This study demonstrates that prompt surgical intervention, before strangulation of the colon occurs, results in low mortality even in city hospital patients.
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PMID:Cecal volvulus. Low mortality at a city hospital. 649 9

A 14-year-old boy presented to the emergency department with abdominal pain. Flat and upright abdominal films and a barium enema revealed the classic findings of sigmoid volvulus. Sigmoidoscopy allowed a soft rubber tube to be passed beyond the obstruction with immediate relief of pain. The patient subsequently underwent a descending sigmoid colectomy. Sigmoid volvulus is a rare entity in childhood. Case discussion and review of the literature is presented.
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PMID:Childhood sigmoid volvulus. 669 16

Five cases of mobile cecum syndrome are presented. These patients all presented with chronic right lower quadrant abdominal pain with associated abdominal distention and symptomatic relief after passing flatus or having a bowel movement. Three patients had preoperative barium enemas demonstrating abnormal mobility of the cecum. On exploration, all patients were found to have the cecum and ascending colon unattached to the lateral peritoneum for 15 to 18 cm. All patients were treated by cecopexy, using a lateral peritoneal flap for fixation, and all have had relief of their pain. This technique is described and illustrated. Cecopexy is an effective method of fixing the cecum and prevents subsequent cecal volvulus. The diagnosis of mobile cecum syndrome should be considered in patients with chronic right lower quadrant pain.
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PMID:Mobile cecum syndrome. 673 64

In reviewing the records of almost 1000 infants and children with intussusception in two children's hospitals over the last 25 yr, there have been seven bowel perforations during attempted hydrostatic barium enema reduction of an intussusception. Except for one instance, these have all occurred during the last 6 yr. The infants were all 6 mo old or less and most had a preceeding viral illness. Only 4 of the 7 had pain, all vomited, in only 2 was a mass felt and all but 1 had rectal bleeding. The duration of these signs and symptoms was longer than 36 hr with most ill for 3 or 4 days. All seven infants had abdominal x-rays that showed complete small bowel obstruction. Once the intussusception was suspected, barium enema reduction was attempted without excessive hydrostatic pressure and not for a prolonged time; all the ileocolic intussusceptions were met in the transverse colon with only a minimal reduction produced. It was at this time that a perforation was suddenly noted. All infants required immediate right hemicolectomy for the area (s) of colonic necrosis. Postoperatively, there were two wound infections, a volvulus which left the child with a short gut and another infant suffered severe brain damage. These babies seem to fit a pattern in which they are younger and sicker longer than the average infant with an intussusception, and have a complete small bowel obstruction. These facts may be a warning that such infants are at increased risk for a barium enema bowel perforation.
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PMID:Colon perforation during attempted barium enema reduction of intussusception. 725 34

Four pediatric patients with volvulus of the right colon, and three others with twisting of the sigmoid colon are reported. The clinical manifestations, mainly pain, were vague. Radiological plain film findings were occasionally characteristic, but were in the majority of cases equivocal. An active radiological approach including a supplementary barium enema in any patient with inconclusive plain abdominal roentgenograms will, in addition to other unexpected diagnoses, reveal rare cases of large bowel volvulus. Elective surgical procedures, carried out on viable bowel do not necessarily provide advantages over a non-operative approach. In addition spontaneous reduction of the volvulus may result in permanent cure.
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PMID:Large bowel volvulus in children. Review of a case material and the literature. 732 51

We report a case of Bochdalek's hernia with volvulus of the stomach and extrapulmonary sequestration in an adult. A 27-year-old woman presented acute respiratory failure, pain in the left side of the chest and recurrent vomiting of sudden onset. Upon examination there was pain in the left hypochondrium that was not tolerated in decubitus position. A chest film showed an "arch" at the base on the left side and an upper gastrointestinal series revealed volvulus of the stomach. After a left thoracotomy, the stomach, spleen and greater omentum were found displaced into the thoracic cavity. After the viscera were confined to the abdomen, the hernia was repaired and the pulmonary sequestration was removed. Two years later, the patient was asymptomatic and a chest film was normal.
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PMID:[Bochdalek's hernia in an adult with stomach volvulus and extrapulmonary sequestration]. 762 24

Over a four year period, from August 1987 to July 1991, thirteen cases of chronic and recurrent gastric volvulus were encountered comprising six paediatric and seven adult patients. In none of the patients was the condition clinically suspected; diagnosis being made only at meticulous upper gastro-intestinal (UGI) barium series. The paediatric patients typically presented with obstructive symptoms of projectile vomiting especially after meals and failure to thrive. The adults had variable symptoms of dyspepsia, recurrent intermittent upper abdominal discomfort or pain, occasionally accompanied by vomiting or retching mimicking many different upper abdominal conditions, such as peptic ulcer, biliary tract or pancreatic disease but with negative findings at endoscopy and abdominal ultrasound scanning. All cases were organo-axial type of gastric volvulus. Associated conditions were small sliding hiatus hernia in two adult cases; partial small bowel malrotation in two cases, high jejunal obstruction also in two cases and congenital hip dislocation in one patient. An infant had umbilical hernia, previous meconium cyst and meconium peritonitis. The condition seems not as uncommon as previously thought; the key to diagnosis being constant awareness, a high index of clinical suspicion and a carefully performed UGI barium series especially during the attack of pain.
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PMID:Gastric volvulus: more common than previously thought? 765 6

Primary linitis plastica of the colon or rectum is a rare entity. Only 85 cases of this type cancer have been reported in the English medical literature. We report two cases, including the oldest known patient presenting uniquely with a sigmoid volvulus and another patient presenting with fecal incontinence and perianal pain. Linitis plastica of the colon or rectum is characterized by presentation in younger patients and is associated with metastatic disease, a high mortality, and insidious growth, often making detection difficult. A high degree of suspicion must therefore be held; a low threshold for endoscopic and echoendoscopic diagnostic intervention also should be maintained. Endoscopic ultrasound provides a unique view of its circumferential infiltrating pattern for diagnosis and staging, but further experience is necessary to establish whether the early use of endoscopic ultrasound favorably impacts mortality.
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PMID:Primary linitis plastica carcinoma of the colon and rectum. 780 17

In a retrospective study of hospital records over a 50-year period, data on 32 patients who died as a result of intestinal obstruction are presented and compared with comparison groups and national mortality statistics. There was a higher incidence and lower mean age at death of fatal intestinal obstruction compared with the total national population. The mean age at death significantly increased over the study period. Intestinal volvulus was a common cause of obstruction particularly in those with cerebral palsy. There was a high prevalence of chronic constipation and megacolon. Foreign-body obstruction was de facto related to pica, but overall, there was a low prevalence of pica. Overall, mean IQ was low, but only significantly so in the male subjects. The length of acute illness was short; in 22 patients it was less than 24 h. Vomiting and abdominal distension were often absent and abdominal signs were recorded only in five patients. Pain or distress was recorded in only nine patients. Only eight patients were correctly diagnosed before death and only two had surgery. The results suggest that fatal intestinal obstruction is more common in mentally handicapped people and chronic constipation and megacolon are risk factors. Intestinal obstruction in mentally handicapped people can present late and with deceptively minimal signs and symptoms.
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PMID:Fatal intestinal obstruction in the mentally handicapped. 794 92

Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact, male Great Danes. The clinical and diagnostic findings were not specific for large bowel volvulus. Clinical signs included peracute to acute onset of vomiting, mild abdominal distention and pain, lack of feces, and tenesmus. Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs. One dog survived.
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PMID:Cecal-colic volvulus in two dogs. 836 6


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