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

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

The pattern of presentation and management of 90 patients treated for sigmoid volvulus over a 7-year period was studied. There was a 9:1 male preponderance and 64% were under 50 years of age. Intestinal obstruction was the presenting feature in 84%, while the rest presented with acute abdomen or pain. Unlike other African series, this constituted only 8% of intestinal obstruction. Sixty-one per cent were managed by sigmoidoscopic decompression and semi-elective sigmoidectomy, and 30% had an emergency operation. A primary anastomosis was undertaken in 71% while others, mainly emergency cases, had a temporary colostomy. There was a 20% morbidity and 12% mortality, 80% of which was in the emergency operation group. It is concluded that the pattern of sigmoid volvulus among Durban Africans differs from that reported in other African countries where young males predominate, and from that in Western societies with elderly female preponderance. When volvulus necessitates emergency surgery, it carries a substantial mortality even in relatively young patients and therefore we advocate resection in all patients during the same hospital admission even in those whose torsion is easily reduced at sigmoidoscopy lest a recurrence fails to reduce.
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PMID:Sigmoid volvulus among Africans in Durban. 855 45

Gastric volvulus or volvulus of the small-bowel can occasionally be found in neonates and small infants. Since volvulus is an emergency case, the radiologist must know the characteristic radiological findings and the ultrasound signs in correlation to the clinical symptoms. Two forms of gastric volvulus can be distinguished: the organoaxial type and a mesenterioaxial form. Besides an idiopathic etiology, diaphragmatic alterations can be observed in children with volvulus of the stomach. Volvulus of the small-bowel occurs in children with malrotation type I or II or with nonrotation. Bile-stained vomiting starts within the first days of life and is followed by the clinical signs of high bowel obstruction and peritonitis. Primarily in cases of gastric volvulus, an ultrasound examination can show the wrong position of the stomach or the pyloric region. In cases of small-bowel volvulus, abnormal localization of the superior mesenteric artery can be demonstrated. The plain film features an upper small-bowel obstruction. Upper intestinal contrast studies may reveal the level of small-intestine obstruction. A contrast enema can rule out a concomitant colon nonrotation or malrotation. A rare form which can be misdiagnosed easily, is volvulus of the sigmoid with pathological elongation and positioning of the sigma. It appears mostly in school children with less urgent symptoms and can disappear spontaneously. A typical feature is pain in the left lower abdomen and complete obstruction in an opaque enema.
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PMID:[Volvulus in childhood]. 934 Jun 72

Laparoscopic surgery has become widely accepted due to its benefits of less post-operative pain and shorter hospital stay. As with any other new technique, there are associated inherent complications. We present a case of cecal volvulus after laparoscopic liver biopsy. This is the first case reported in the literature of cecal volvulus secondary to laparoscopy.
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PMID:Cecal volvulus after laparoscopic liver biopsy. 957 55

A 55-year-old woman had recurrent bouts of low substernal and epigastric pain radiating into the interscapular region. A hepatobiliary scan initially showed what was believed to be a dilated common bile duct and nonvisualization of the gallbladder. A delayed image obtained after having the patient move about revealed the presence of a filled gallbladder and normal common bile duct. The combination of recurrent pain with this scintigraphic picture may be representative of a floating gallbladder or an incomplete torsion with spontaneous detorsion. This case is presented to describe the scintigraphic appearance of a mobile gallbladder that may be prone to volvulus and to emphasize the importance of obtaining decubitus or oblique views at the end of a hepatobiliary study in selected cases of unusual findings.
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PMID:Floating gallbladder: a questionable prelude to torsion: a case report. 1069 12

The intestinal obstruction by Meckel s diverticulum is caused by an adherence, volvulus or invagination affecting this diverticulum. This is not a very frequent event and our purpose is to describe a case of intestinal obstruction by a bridle formed by Meckel s diverticulum. Clinically, the patient experienced pain in the periumbilical region, abdominal distension and bilious vomits. The exploratory laparotomy evidenced the existence of Meckel s diverticulum without signs of inflammation.
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PMID:[Intestinal obstruction by Meckel's diverticulum: a case study]. 1217 70

Vomiting or its lesser stages-anorexia, nausea-is a prime symptom of the most serious surgically curable diseases of childhood. In the newborn, when vomitus is green, abdomen scaphoid, and erect roentgen view shows air-fluid levels in stomach and duodenum with gas beyond, partial duodenal obstruction is present and midgut volvulus with malrotation is likely enough to justify immediate exploration. In infancy, vomiting is a clear sign of intussusception when associated with intermittent colicky pain, palpable mass and "currant-jelly" feces. These symptoms are not always present, and if there is blood in the feces, barium enema study must follow. In further doubt, exploration may be justified. In childhood, a common early symptom of appendicitis is vomiting accompanied by pain without any complete remission. Constipation is frequent but diarrhea may occur and contribute to an impression of gastroenteritis. Complete and repeated physical examination, with a history of the above symptoms, should lead to correct diagnosis.
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PMID:Vomiting as a symptom of serious disease in infants and children. 1382 64

The subject of malrotation and midgut volvulus in infancy and childhood is reviewed from the perspective of experience with 138 patients evaluated in a published series and a further 82 cases seen since. Embryology, historical aspects, clinical presentation, investigation, surgery, and outcome are discussed. The diagnosis of malrotation and volvulus should always be kept in mind when assessing any infant or child with symptoms of vomiting and pain, particularly when the vomiting is bile-stained. The diagnosis cannot be excluded if diarrhea is present, when clinical findings are bland, or even with normal abdominal radiographs. A contrast meal and follow-through should be done and, if correctly interpreted, should be diagnostic. Ultrasound examination may be helpful but is not secure enough to exclude the diagnosis. Laparotomy or laparoscopy is the only way to be sure. Malrotation with its propensity for volvulus is truly a time bomb lying within.
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PMID:Malrotation and volvulus in infancy and childhood. 1465 61

In Cameroon, a 3-year randomized, double-blind controlled trial was conducted to determine if ivermectin, given at 3-monthly intervals and/or at high doses (800 microg/kg), had a greater effect on adult Onchocerca volvulus than standard annual doses of 150 microg/kg. Adverse reactions were recorded and analysed in a logistic regression model with random effects to assess the influence of the dose and rhythm of treatment on their occurrence. After the first dose, 3-monthly treatment was associated with a clearly reduced risk of reactions, especially oedematous swellings, pruritus and back-pain. Oedematous swellings and subjective ocular troubles were found to be associated with high doses of ivermectin. These results reinforce former parasitological conclusions that it would be desirable to evaluate the feasibility and effects on transmission of large-scale 3-monthly treatments with standard doses of ivermectin for onchocerciasis control. Owing to the unexpected ocular reactions, the use of high doses to counteract any future resistance of O. volvulus to ivermectin should be considered with caution.
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PMID:Adverse systemic reactions to treatment of onchocerciasis with ivermectin at normal and high doses given annually or three-monthly. 1518 39

Human infection with Onchocerca volvulus was investigated in 13 rural communities in the Upper Imo River basin, Imo State, Nigeria between March 1997 and December 2000 using the skin snip method. Of the 3,311 persons examined, 889 (26.8%) had microfilariae. There were significant differences between communities in microfilariae prevalence and intensity of infection (P<0.05). Sex infection was similar in males (26.8%) and females (26.9%); whereas farmers (46.6%) and fishermen (28.4%) were more affected than people in other occupations. The proportion of infected persons increased with age coinciding with the period when most clinical signs manifest. A significant proportion of the 889 persons with positive microfilariae skin biopsy had musculoskeletal pain (57.1%). Thirty-four (47.2%) of the 72 epileptics identified had positive skin biopsy in addition to other manifestations. The present findings show that onchocerciasis is a public health problem in the area. The use of ivermectin has reduced the incidence of the disease when compared with data from the pre-ivermectin era. This shows that Community Directed Treatment with Ivermectin (CDTI) campaign is successful and should be sustained until onchocerciasis is eliminated as a public health problem in the area.
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PMID:Onchocerciasis in Imo state, Nigeria (2): the prevalence, intensity and distribution in the upper Imo river basin. 1538 15


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