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

Premature infants presenting to the neonatal intensive care unit at the Hospital for Sick Children with a surgical abdomen over a 5-year period were studied retrospectively to determine the factors leading to the diagnosis of malrotation with volvulus and necrotizing enterocolitis (NEC). Fifteen preterm infants (less than 37 weeks) were diagnosed as having volvulus, and 54 had surgically treated NEC. Those with NEC were more likely to be systematically ill with grossly bloody stools, abdominal tenderness, and thrombocytopenia (P less than .005). Bilious vomiting and bilious gastric residuals were the only hallmarks of volvulus (P less than .005). Although the radiographic findings of thickened bowel walls and intramural air were significantly related to NEC, the accuracy and interobserver reliability in diagnosing these features was variable as was the ability to distinguish NEC from volvulus or normal on plain abdominal radiographs. Volvulus is an important cause of surgical abdomen in the preterm infant and can be misdiagnosed as NEC. An unusual course or the presence of bilious vomiting in any patient thought to have NEC should alert the clinician to the possibility of this diagnosis.
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PMID:Necrotizing enterocolitis and volvulus in the premature neonate. 277 84

Fifty-seven of 101 Nissen fundoplications during the 4-year period, July 1979 to July 1983, were performed on neurologically impaired children. Mean age at the time of surgery was 5.9 years (range 1 month to 22 years). Indications for operation included: persistent vomiting, 57 patients (100%); failure to thrive, 49 patients (86%); repeated episodes of pneumonia, 49 patients (86%); esophagitis, 18 patients (32%); hiatal hernia, 14 patients (25%); episodes of apnea, 10 patients (18%); and esophageal stricture, six patients (10%). Forty-six of the 57 patients had previously failed a standard trial of nonsurgical management. Gastroesophageal reflux was documented by barium esophagograms in 51/56 patients (91%), chalasia scans in 28/32 patients (88%), esophagitis or stricture at endoscopy in 21/23 patients (91%), and acid reflux on pH monitoring in 13/16 patients (80%). Operative management included gastrostomy in 55 of the 57 patients and this was permanent in 50. Gastrostomies had previously been performed in nine patients but had failed to provide a reliable method of enteral feeding because of chronic reflux and aspiration. The surgical complication rate was 12%. Intraoperative esophageal perforation occurred in two patients, splenic tear in one, hepatic vein laceration in one, and a tight wrap in one. After surgery, bowel obstruction from adhesions developed in one patient and a midgut volvulus in another. Five of the children have died, none from causes related to the surgical procedure. Clinical and radiologic follow-up evaluations of all survivors have been done, with a mean follow-up of 3 years. In four patients the repair was felt to be inadequate. One patient had an esophageal stricture and three had recurring episodes of pneumonia. Three children showed radiologic evidence of persistent reflux, but only two were symptomatic. Two patients required a second antireflux procedure for reflux and are now free of symptoms. Nissen fundoplication appears to be a safe and beneficial procedure in neurological impaired children. Long-term follow-up evaluation of these patients showed satisfactory growth as well as a significant decrease in pulmonary disease associated with aspiration.
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PMID:The effectiveness of Nissen fundoplication in neurologically impaired children with gastroesophageal reflux. 2325 71

Six neonates with midgut malrotation and volvulus were explored with ultrasonography before surgery. In each case, ultrasound detected an abnormal position of the superior mesenteric vein with regard to the superior mesenteric artery, indicating a midgut malrotation. In 4 patients, a propeller-like image was present around the superior mesenteric axis, demonstrating an associated volvulus. In 2 patients, there was a tumor-like presentation of the volvulated small intestine. Compared to the intestinal opacification, ultrasound seems to be a simple and rapid method to explore the neonate with vomiting or acute abdomen.
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PMID:[Echographic aspects of midgut malrotation with volvulus in the newborn infant]. 305 1

The authors report an unusual case of newborn obstruction by Meckel's diverticulum. Symptoms were repeated vomiting and a rounded mass was palpated in right lower quadrant. This mass looked like a fecalith on X Rays which also showed dilated gas filled loops of intestine. A barium enema showed no trouble of rotation, a good filling of last loops of small bowel, then a large kind of pocket, filled from the bowel. Operation discovered a huge (6 x 5 cm) Meckel's diverticulum compressing small intestine and pushing the cecum towards the upper quadrant. Treatment was ileal resection followed by end to end anastomosis. A very few newborn obstructions by Meckel's diverticulum were published; mechanisms are intussusception, volvulus, herniation. No similar case as reported was found in literature.
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PMID:[A rare cause of neonatal occlusion by a palpable abdominal mass: Meckel's diverticulum]. 316 1

In 261 infants with vomiting, 11 duodenal abnormalities were diagnosed with fluid-aided ultrasound (US). These abnormalities included duodenal obstruction, malrotation with and without associated volvulus, incomplete rotation, and duodenal stenosis. US was the initial modality used in the evaluation of vomiting in these neonates and young infants. The overall sensitivity and specificity of fluid-aided US evaluation of duodenal abnormalities were 100% and 99%, respectively. (Workup bias limits the reliability of these figures.) Fluid-aided US examination of the stomach and duodenum provided a dynamic view of duodenal rotation and anatomy, and at the very least provided a method of triaging those infants who may require surgery, upper gastrointestinal series, or follow-up US to make a definitive diagnosis.
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PMID:Neonatal duodenum: fluid-aided US examination. 330 23

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

Intestinal malrotation without volvulus in infants and children is often difficult to diagnose because of less dramatic clinical features, e.g. failure to thrive and intermittent bile stained vomiting, compared to the patients with volvulus. A plain x-ray of the abdomen may show the characteristic "double bubble sign", otherwise a barium meal will give the diagnosis. A follow-up study of 18 patients of whom 14 had an operation showed that all but one were free of symptoms after a median observation period of 205 months (range 20-317). It is concluded that any patient presenting with a symptomatic intestinal malrotation should be offered an operation except for the type with a mobile caecum.
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PMID:Intestinal malrotation without volvulus in infancy and childhood. 356 7

Intussusception in neonates is rare. The authors report the second case in the Western literature of neonatal intussusception presenting as pneumoperitoneum. A male infant was referred 30 hours after birth because of possible midgut volvulus after emesis and failure to pass meconium. An abdominal x-ray film revealed a large amount of free air in the peritoneal cavity. At operation a type 3 jejunal atresia was found, with a 2-mm perforation in the dilated proximal end and a viable intussusceptum just inside the distal end. The authors conclude that this case represents an atresia secondary to inutero intussusception, with perforation occurring after birth (secondary to air-swallowing and gastrointestinal secretions).
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PMID:Jejunal atresia secondary to intrauterine intussusception, presenting as acute perforation. 358 Sep 81

Until 1980, 300 cases of gastric volvulus had been reported in the literature. Of these only 50 had presented in children. The disease is considered rare. We reviewed our experience at Sainte-Justine, in the last 30 years and found 10 cases, all of which diagnosed since 1980. Four patients were under one year of age. The other six were between 3 and 17 years old. In five the presentation was acute and three had had similar previous episodes. In 5 patients the presentation was chronic and in four of these the symptoms dated from birth. Seven associated anomalies were present in 6 cases. Diagnosis was made by x-rays. Eight patients were treated successfully with gastropexy. One premature baby was treated medically. Perhaps this entity is more common than generally thought. It should be suspected in an infant with regurgitation or vomiting and failure to thrive, and in a child with chronic, intermittent or acute upper abdominal pain and distension.
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PMID:[Gastric volvulus in children]. 360 87

Gastric volvulus is a rare cause of respiratory distress and vomiting in neonates. This diagnosis was suspected in a 4 week old baby with acute respiratory distress accompanied with vomiting, from the results of an esophagogastroduodenal radiological examination. At operation a gastric volvulus was confirmed, associated with an anatomical malformation: absence of gastrosplenic omentum predisposing to gastric volvulus with mesenterio-axial rotation. Gastropexy was followed by an uncomplicated postoperative course. A literature review confirmed rarity of this affection and raised the problem of causes of repeated vomiting in the newborn and premature infant. An often incriminated lesion is gastric plicature, a radiological notion, whereas gastric volvulus is accompanied necessarily by an altered uptake of contrast in the stomach. Acute volvulus must be distinguished from other types of volvulus, notably that observed during hiatus hernia. Early diagnosis allows rapid surgical treatment by anterior gastropexy as recommended by most authors.
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PMID:[A case of acute gastric volvulus in a newborn infant]. 360 92


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