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

Experimental closed loop small intestinal volvulus was studied in the anesthetized horse. Volvulus was simulated by ligation of the mesenterial veins to a segment of small intestine. Physical signs and hemodynamic, hematologic, clinical chemical, bacteriologic and peritoneal fluid values were examined. Compared to conscious horses anesthesia highly delayed and modified the clinical signs of shock (changes in mucosal colour, dehydration, decreased skin temperature, elevated pulse rate, low blood pressures) and of small intestinal volvulus (altered peristalsis, gastric dilation). Plasma glucose response to shock was also modified by unconsciousness. However, a dose response relationship was indicated between the extent of small intestinal damage and clinical symptoms. The same was applicable to changes in blood pressures, blood acid-base balance, lactate, potassium, chloride, glucose, inorganic phosphorus, creatinine, creatine kinase, red blood cell and total white blood cell counts and serum total protein. The relationship was also indicated in the following peritoneal fluid values: volume, lactate, pH, total white cell counts, alkaline phosphatase and bacteriology. Changes related to shock (insufficient tissue perfusion) were low blood pressures and metabolic acidosis due to anaerobic glycolysis with accumulation of lactic acid. Also low plasma glucose and elevated plasma potassium, creatinine, inorganic phosphorus and creatine kinase were regarded as consequences of shock.
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PMID:Simulated small intestinal volvulus in the anesthetized horse. 52 13

Description of a total of 236 cases of intestinal volvulus of which, 141 cases concerning the small intestine, 2 of the transverse, 13 of the caecum and 80 of the sigmoid. Detailed discussions are made on each type of volvulus, the etiology, pathogenesis, pathological anatomy, while particular extensions is given to the description of the results obtained that are compared with the data found from the examination of the literature. A separate treatment is reserved to the anaesthesia in the cases of intestinal acute volvulus and particularly to some technical measures to which is to be submitted the patient who suffers from mechanical occlusion with serious intestinal ache.
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PMID:[Anesthesia in particular cases of acute abdomen (volvulus of the intestine)]. 55 63

Before a decision on the anesthetic protocol and the various patient support measures can be taken, the pathophysiological changes that occur during a gastric dilatation-volvulus need to be evaluated. The most important changes are of a circulatory and/or respiratory nature, inducing hypotension, hypovolaemia, cardiac dysrhythmias, a decreased respiratory minute volume, and subsequently resulting in changes in the acid-base balance and plasma electrolyte concentration. In view of these changes and the increased anaesthetic risk for the patient with gastric dilatation-volvulus, the use of barbiturates or ketamine cannot be recommended for anaesthetising these patients. With the use of neurolept-analgesic combinations, such as methadone-droperidol or sufentanil-midazolam, an increased cardiovascular stability and an ample analgesic effect can be obtained. Especially with the potent sufentanil in combination with midazolam, an excellent anaesthesia for patients with gastric dilatation-volvulus can be achieved.
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PMID:[Anesthesia in the patient with stomach dilatation-volvulus]. 200 62

A retrospective study of 40 horses that underwent surgical treatment for sand colic was performed. Three horses were euthanatized and one died during surgery. Of the 36 horses that recovered from anesthesia, five died before discharge from the hospital and seven died after discharge. Twenty-four horses survived at least 12 months. Sand impaction of the right dorsal colon was present in 26 horses. In addition to sand impaction, 10 horses also had colonic displacement or volvulus.
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PMID:Surgical treatment of sand colic. Results in 40 horses. 292 38

Cecal volvulus in a dairy cow with vascular compromise of the proximal portion of the ascending colon was corrected surgically with preservation of the ileocecocolic junction. Partial cecectomy was combined with resection of the proximal portion of the ascending colon and anastomosis of the remaining cecum to the distal portion of the ascending colon. The procedure was done with the use of mechanical suturing devices while the cow was standing. Previously, general anesthesia and relocation of the ileocecocolic junction had been suggested.
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PMID:Cecal volvulus in a dairy cow: partial resection of the proximal portion of the ascending colon. 365 17

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

Gastric dilatation-volvulus (at 30 mm of Hg of gastric pressure) was experimentally induced in 8 dogs under sodium pentobarbital anesthesia. Hemodynamic indices including cardiac output, mean aortic pressure, left ventricular end diastolic pressure, heart rate, total peripheral resistance, and dp/dtmax were measured during a 180-minute period of gastric dilatation-volvulus and for 120 minutes after gastric decompression. Experimental gastric dilatation-volvulus resulted in significant (P less than 0.05) decreases in cardiac output (64%), mean aortic pressure (48%), left ventricular end diastolic pressure (68%), and ventricular dp/dtmax (32%) compared to 4 control dogs. Hemodynamic indices returned toward control values after gastric decompression. It was concluded that gastric dilatation-volvulus in the present experiment was capable of inducing hemodynamic alterations of a magnitude similar to those reported in gastric dilatation studies, using higher gastric pressures.
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PMID:Hemodynamics during experimental gastric dilatation-volvulus in dogs. 662 1

Two hundred ninety-five case records were included in an analysis of dogs treated by a standardized protocol for gastric dilatation/volvulus syndrome between 1986 and 1992. A breed predisposition was demonstrated for Great Danes, German Shepherd Dogs, large mixed-breed dogs, and Standard Poodles. One hundred and ninety-three dogs had gastric dilatation and volvulus (GDV) confirmed at surgery, 66 had simple gastric dilatation (GD), and 36 others had gastric dilatation but volvulus could not be proved or disproved (GD +/- V). Among dogs with GDV, the fatality rate was 15% (29/193). Twenty-six (13.5%) dogs with GDV underwent partial gastrectomy, and 8 (31%) died or were subsequently euthanatized. In comparing the group of dogs with GDV that survived to those that died, there were no statistical differences in the age of dog, time between onset of clinical signs and admission, time from admission to surgery, or duration of anesthesia. Cardiac arrhythmias were detected in 40% (78/193) of the dogs with GDV. There also was no statistical correlation between development of a cardiac arrhythmia and outcome in dogs with GDV. The causes of death in dogs with GDV were multiple and varied; presumed gastric necrosis was a common reason for intraoperative euthanasia (11 dogs). Among dogs with GD or GD +/- V, the fatality rate was 0.9% (1/102).
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PMID:Canine gastric dilatation/volvulus syndrome in a veterinary critical care unit: 295 cases (1986-1992). 759 46

The morphologic changes following ascending colon volvulus result from the interaction of inflammatory and coagulation mediators. The objective of this study was to establish a quantifiable histopathologic scoring system to evaluate the serial pathomorphologic changes during ischemia and reperfusion. Such a scoring system could then be applied to subsequent studies designed to attenuate bowel lesions by regulating activity of individual mediators. Ten normal, healthy adult ponies were randomly divided into two equal groups. Following anesthesia and a 30-minute stabilization period, the colon of ponies in the experimental group was twisted 720 degrees for 2 hours of ischemia and then untwisted for 2 hours of reperfusion. The control ponies underwent 4 hours of anesthesia. Full-thickness colonic biopsy specimens were obtained from the antimessenteric border of the pelvic flexure and prepared for light and transmission electron microscopy at 0, 1, 2, 3, and 4 hours after twisting. The mean histopathology score at 0 hours for control ponies was 1.2 and remained unchanged; the score for the experimental ponies was 1.8 and progressed to 4.2 by 4 hours. At 2 hours of ischemia, there was edema of the submucosa and lamina propria attributable to accumulation of platelets, fibrin, and neutrophils in capillaries of the lamina propria. The morphologic changes in experimental ponies progressed to complete destruction of the mucosa with congestion, hemorrhage, and microvascular thrombosis. Mean histopathology scores of control and experimental ponies were significantly different at 1 hour of ischemia, and lesions progressively worsened through the reperfusion period.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Morphologic changes of the ascending colon during experimental ischemia and reperfusion in ponies. 760 95

A 21-year-old white male with Rubinstein-Taybi syndrome (RTS) underwent emergency laparotomy and volvulus reduction for a strangulated ileus. Low blood pressure, rapid heart rate and dusky skin color indicated that he was in a hypovolemic and/or septic shock state. Communication with the patient was impossible because of severe mental retardation, deafness, and blindness, and he was quite combative and agitated. Because of an urgent situation and in anticipation of a great risk of regurgitation, no sedatives or anesthetics were used for induction of anesthesia. A large dose of vecuronium with a priming principle technique was the only agent used for endotracheal intubation. Vigorous fluid replacement and appropriate catecholamine therapy were required for the perioperative management and recovery from the shock state. Any cardiac episodes which have been reported in patients with RTS, such as supra-ventricular or ventricular arrhythmia, did not occur throughout the perioperative period. Lack of communication with the patient was an obstacle in the postoperative care, such as respiratory management or the estimation for the timing of extubation. In conclusion, the preparations for a possibly difficult airway and the possible occurrence of arrhythmia were thought to be prudent for the management of the patient with RTS.
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PMID:[Emergency operation and perioperative management for a patient with strangulated ileus and shock associated with Rubinstein-Taybi syndrome]. 793 9


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