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)

Rates of perforation for different types of IUDs vary from 1 per 150 insertions with the bow to 1 per 2500 with the loop. Incidence of perforation varies with insertion technic. Not all perforations occur at the time of insertion but most do. These perforations may be partial or complete, with or without symptoms, and complications range from mild anxiety to life-threatening situations. With the older closed-loop devices intestinal strangulation was a threat. Partial perforations have been identified as sources of intestinal volvulus and septic abortions. With the increase use of IUDs and the increased frequency of perforations, a technic simpler than laparotomy was desired to remove intraperitoneal devices. Laparoscopy seems safer and is associated with fewer side effects than laparotomy. Before attempting removal, the patient is examined to determine if the string attached to the IUD can be seen. In 18% of women with retracted strings perforation is present. The uterus is probed to detect the IUD. A plain x-ray of the abdomen is taken to rule out unnoticed expulsion. If the x-ray reveals the IUD, a hysterosalpingogram is performed with both autero-posterior and lateral views using 40% iodized oil. Laparoscopy is performed under general anesthesia with the patient in the lithotomy position. The uterus is manipulated by a tenaculum on the cervix. The abdomen is distended with gas, 3-4.5 liters. The patient is then slowly moved into the Trendelenburg position to allow the omentum and intestines to withdraw from the pelvis. When the IUD is found, it can be grasped by Eder tongs and withdrawn. Lippes Loops were removed from 5 patients by this method. All recovered uneventfully. Left lower quadrant pain was the only symptom complained of before the operation. 1 patient had been pregnant and after a successful delivery the extrauterine IUD was removed 1 day postpartum. Laparoscopy produces minimal surgical trauma, the postoperative course is short, and morbidity has not been encountered. Tubal coagulation could be done at the same time if desired.
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PMID:Removal of intrauterine contraceptive devices after uterine perforation. 426 40

The case of an 18-year-old man with sigmoid volvulus and recurrent abdominal pain is presented. He was seen in the emergency department three times in a 4-month period, each time complaining of cramping left lower quadrant pain of one to two hours duration without vomiting or diarrhea. Physical examination on each occasion revealed left lower quadrant tenderness without mass, guarding, or rebound. Radiologic evaluation on the first visit revealed sigmoid volvulus, which was reduced by barium enema. Despite identical clinical presentation on two subsequent occasions, radiologic studies showed no evidence of recurrent volvulus. During the ensuing two years, the patient has had no further symptoms.
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PMID:Sigmoid volvulus in a young patient. 647 22