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

Fifty consecutive left-sided colorectal cases are described in which intra-operative colonic lavage (IOCL) was used. Sixteen were acute or sub-acute cases, including five with total colonic obstruction. The anastomoses were usually hand-sutured and no colostomies were used: all procedures were single stage. Only one case was considered to have possibly had an anastomotic leak (2.0%) and the average hospital stay was 16 days. There were 3 wound infections (6%). Peri-operative mortality was 6% and no deaths occurred in the acute or sub-acute cases. The procedure allows safe one-stage operation in most acute left-sided colonic lesions and provides the most thorough colonic preparation for elective cases, thus obviating the need for colostomy in cases where the colon is found to be inadequately prepared, or in very low anastomoses. The technique described for IOCL is readily reproduced, attendant with negligible risk of complications and takes relatively little extra operating time. Defunctioning colostomy is unlikely to be necessary with this method, thereby saving patients considerable discomfort and nuisance, time in hospital and the potential morbidity of further operation. Specific recommendations for use of IOCL are: acute or sub-acute left colonic obstruction: stenosing or volvulus; massive colonic haemorrhage: for diagnostic and preparatory use; rectal and left colonic trauma; left colonic surgery where inadequate pre-operative bowel preparation has occurred; 'low' elective restorative rectal resection; and preparation for colonic replacement of oesophagus.
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PMID:Intra-operative colonic lavage: safe single-stage, left colorectal resections. 199 86

Laparoscopic assisted sigmoidectomy was the technique of choice for a mentally retarded adult male with severe seizure disorder and recurrent sigmoid volvulus in an effort to reduce post-op stress and discomfort and thereby diminish the possibility of exacerbation of his seizures. The technique was performed using standard laparoscopic technique and a 5cm incision in the left abdomen to perform extracorporeal bowel anastomosis. The surgery was successful and the patient experienced minimal post op discomfort, no complications and had no seizures. This newest addition to the portfolio of laparoscopic surgical techniques may be a useful tool in high risk or elderly patients who are poor candidates for conventional bowel surgery.
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PMID:Laparoscopic colectomy for sigmoid volvulus. 849 50

The filarial parasites that affect humans most seriously include Onchocerca volvulus, Wuchereria bancrofti, Brugia malayi and Loa loa. In general, these species cause disease that is debilitating long before it is fatal, producing clinical manifestations such as general malaise, pruritus and lichenification of the skin, lymphangitis, elephantiasis and blindness(1). As a result, infection with any one of these organisms is physically, as well as economically, devastating. Currently, the pharmacological armamentarium with which to treat filarial infections is very limited and many of the drugs that are known to be efficacious against these worms may produce side effects that cause extreme discomfort. Here, Elizabeth Vande Waa describes the quest for new chemotherapeutic approaches for the treatment of filarial infections.
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PMID:Chemotherapy of filariases. 1546 92

Diaphragmatic herniation has been recognized as a complication of unrepaired diaphragmatic defects after left ventricular assist device explantation and cardiac transplantation. We believe this to be the 1st report of diaphragmatic herniation that resulted in gastric volvulus in a cardiac transplant recipient. The presentation, diagnosis, and treatment of this potentially fatal condition are discussed herein. Nine months after removal of a Thoratec HeartMate II left ventricular assist device and orthotopic cardiac transplantation, the patient presented with intermittent upper abdominal and lower chest discomfort of 3 weeks' duration. Physical examination was notable for fullness in the upper abdomen. Plain radiographs and computed tomographic scans of the chest and abdomen without contrast were unexceptional. Two weeks later, the patient's pain began to worsen rapidly, and an upper gastrointestinal barium study revealed partial herniation of the stomach into the chest and omento-axial gastric volvulus without luminal obstruction. The patient underwent uncomplicated laparotomy for repair of the diaphragmatic defect and reduction of the herniated stomach. This case highlights the need for increased awareness of diaphragmatic herniation as a complication of unrepaired diaphragmatic defects so that diagnosis is not delayed, and underscores the importance of primary repair of all such defects to prevent future complications.
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PMID:Gastric volvulus after ventricular assist device explantation and cardiac transplantation. 1742 Aug 7

A 73-year-old man underwent laparoscopic repair of intrathoracic gastric volvulus after presenting with chest discomfort and inability to belch. After a few weeks, he developed early satiety, nausea and postprandial bloating and was found to have developed a tight stenosis 2 cm proximal to the pylorus. He underwent a series of endoscopies with balloon dilation with full resolution of symptoms and is doing well at 1-year follow-up. Gastric volvulus with ischemia resulting in a stricture has not been previously reported.
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PMID:Incarcerated intrathoracic stomach with antral ischemia resulting in gastric outlet obstruction: a case report. 1826 58

Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasingly popular. They were originally designed to reduce colonic spasms, facilitate cecal intubation, and lower patient discomfort and the need for sedation. These maneuvers straighten the rectosigmoid colon and enable the colonoscope to be inserted deeply without causing looping of the colon. Water-immersion colonoscopy minimizes colonic distension and improves visibility by introducing a small amount of water. In addition, since pain during colonoscopy indicates risk of bowel perforation and sedation masks this important warning, this method has the potential to be the favored insertion technique because it promotes patient safety without sedation. Recently, this water-immersion method has not only been used for colonoscope insertion, but has also been applied to therapy for sigmoid volvulus, removal of lesions, lower gastrointestinal bleeding, and therapeutic diagnosis of abnormal bowel morphology and irritable bowel syndrome. Although a larger sample size and prospective head-to-head-designed studies will be needed, this review focuses on the usefulness of water-immersion colonoscopy for diagnostic and therapeutic applications.
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PMID:Diagnostic and therapeutic applications of water-immersion colonoscopy. 2607 84

We report the case of a 7-year old girl presenting with sub-occlusive syndrome associated with acute paroxysmal abdominal pain at the level of the upper abdomen, vomiting and no evacuation of faeces. Physical examination showed discomfort with palpation of the upper abdomen. Abdominal ultrasound showed poorly limited intraperitoneal tissue formation without vascular features on doppler, exercising a mass effect on the neighborhood structures; mesenteric vessels were in their normal position. This mass on CT scan scorresponded to a well limited lipomatous formation exercising a mass effect on the caecum associated with volvulus of the small intestine. The diagnosis of volvulus of the small intestine caused by mesenteric lipoma was retained. Surgical exploration confirmed this diagnosis. The patient underwent unrolling of the small intestine and lipoma enucleation. The postoperative course was uneventful after a follow-up of 6 months. Anatomo-pathological examination confirmed the lipomateuse nature of the mass.
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PMID:[Volvulus of the small intestine caused by mesenteric lipoma]. 2881 97

Large bowel obstruction (LBO) is a potential surgical emergency, commonly caused by colorectal carcinoma, diverticular stricture, and volvulus. LBO secondary to chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) is a rare occurrence. We report an 81-year-old man with a history of CLL/SLL who presented to the emergency department with episodes of abdominal cramps and discomfort, diarrhea, vomiting, subjective flushes, and sweats. After a thorough evaluation, the patient was found to have a malignancy-mediated mechanical LBO at the hepatic flexure due to colonic compression by extensive pericolic lymphadenopathy. After resuscitation and medical optimization, an urgent laparotomy with oncologic right hemicolectomy was performed. Analysis of resected specimens, including lymph nodes, revealed atypical CD23- CLL/SLL cells. Postoperatively, aside from temporary ileus, the patient recovered well and was discharged home.
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PMID:Large Bowel Obstruction in the Setting of Small Lymphocytic Lymphoma. 3292 40