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

Six cases of splenic flexure volvulus were studied over a 14-year period. The patients were aged 15-62 years. Five of the six patients were mentally retarded, lifelong residents of a long-term-care institution. Two patients had congenital absence of normal colonic attachments; the other four patients had elongated mesocolons, presumably from chronic constipation. All patients underwent abdominal radiography, followed by a barium enema study. In the appropriate clinical setting, radiographic diagnosis of a splenic flexure volvulus is suggested when the following are seen: (a) a markedly dilated, air-filled colon wtih an abrupt termination at the anatomic splenic flexure; (b) two widely separated air-fluid levels, one in the transverse colon and the other in the cecum; (c) an empty descending and sigmoid colon; and (d) a characteristic beak at the anatomic splenic flexure at a barium enema examination.
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PMID:Volvulus of the splenic flexure: radiographic features. 188 35

Scleroderma of the colon is commonly associated with constipation, as was the case in a 70-year-old woman with rectal prolapse described by the authors. The chronic constipation in this patient may have been the cause of her rectal prolapse, but the onset of the prolapse and scleroderma at about the same time suggest that the scleroderma may have been a causative factor. A Ripstein repair of the prolapse was carried out. The authors discuss some of the complications of colonic scleroderma, which include megacolon, transverse and sigmoid colonic volvulus, telangiectasia, stenosis and diverticula and stercoral ulceration.
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PMID:Rectal prolapse in scleroderma: case report and review of the colonic complications of scleroderma. 397 Dec 25

Sigmoid, cecal and transverse colon volvulus have been responsible for approximately 3% of all large bowel obstruction in the United States. Transverse colon volvulus is much less frequent, occurring in less than 4% of all reported cases of colonic torsion. In the pediatric age group a review of the literature revealed seven cases only, to which we are able to add an eighth. Predisposing abnormalities implicated in the etiology of volvulus of the transverse colon include a redundant transverse colon, an elongated mesentery and close attachment or lack of fixation of the proximal and distal transverse colon. Chronic constipation and mental retardation are associated with this condition. The treatment is surgical intervention to untwist the volvulus and resect the redundant and often nonviable colon with primary colocolostomy or end-colostomy and mucous fistula as indicated.
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PMID:Volvulus of the transverse colon in children--Report of a case and review of the literature. 673 Jul 9

In a retrospective study of hospital records over a 50-year period, data on 32 patients who died as a result of intestinal obstruction are presented and compared with comparison groups and national mortality statistics. There was a higher incidence and lower mean age at death of fatal intestinal obstruction compared with the total national population. The mean age at death significantly increased over the study period. Intestinal volvulus was a common cause of obstruction particularly in those with cerebral palsy. There was a high prevalence of chronic constipation and megacolon. Foreign-body obstruction was de facto related to pica, but overall, there was a low prevalence of pica. Overall, mean IQ was low, but only significantly so in the male subjects. The length of acute illness was short; in 22 patients it was less than 24 h. Vomiting and abdominal distension were often absent and abdominal signs were recorded only in five patients. Pain or distress was recorded in only nine patients. Only eight patients were correctly diagnosed before death and only two had surgery. The results suggest that fatal intestinal obstruction is more common in mentally handicapped people and chronic constipation and megacolon are risk factors. Intestinal obstruction in mentally handicapped people can present late and with deceptively minimal signs and symptoms.
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PMID:Fatal intestinal obstruction in the mentally handicapped. 794 92

Volvulus of the transverse colon is a very rare entity, representing 1 to 3.4% of all volvuli of the colon. We report three cases illustrating the problems of this pathology. The presentation is usually acute, leading to prompt surgery. Multiple etiologies may be combined: congenital malrotations of the gut, chronic constipation in the elderly enhanced by psychiatric medications, and mechanical by adhesion bands which help to create anomalous rotation axes for the volvulus. The best treatment must be surgical, and we recommend an aggressive approach: an extended right colectomy, which gave good results in our patients.
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PMID:[Volvulus of the transverse colon. Apropos of three cases]. 821 71

Sigmoid volvulus is an unusual cause of intestinal obstruction in children. We report two cases of sigmoid volvulus as a complication of segmental dilatation of the colon occurring in two girls (5 years old and 9 years old) previously treated for chronic constipation. In both cases the constipation had been recognised since the neonatal period mimicking a Hirschsprung's disease, a diagnosis which has been excluded after rectal biopsy. The delayed diagnosis of segmental dilatation of the sigmoid colon followed the volvulus. Segmental colonic resection resulted in both cases in the cure of the constipation.
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PMID:Volvulus of the sigmoid colon as a complication of segmental dilatation of the colon. Report of 2 cases. 900 77

Acute and chronic constipation are common conditions. In most instances, a thorough history and digital rectal examination provide sufficient information to begin treatment. Occasionally, imaging studies can be useful to confirm the presence of a suspected abnormality. The acute onset of constipation suggests colonic obstruction. Plain abdominal radiographs may be sufficient to determine the level and cause of the obstruction, such as sigmoid or cecal volvulus. Barium enema radiographic examination or colonoscopy may also be useful to detect the cause of obstruction. In patients with chronic constipation, plain abdominal radiographs can be used to show the extent of fecal impaction. Colonic transit time can be assessed on serial abdominal radiographs after the patient has ingested radiopaque markers. Evacuation proctography can be used to diagnose a variety of functional disorders of the rectum and anus, such as rectocele, intussusception and abnormal perineum floor descent.
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PMID:Diagnostic imaging in the evaluation of constipation in adults. 926 31

A case of transverse colon volvulus in a 10-year-old female child with trisomy 13 is reported, bringing the total number of cases of children reported in the English language medical literature to 14. Although this type of volvulus is rare, a definite pattern is noticeable, so we should suspect its diagnosis in a patient with chronic constipation, mental retardation and motor disturbances. Resection of the involved segment and primary anastomosis is the definite treatment.
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PMID:Volvulus of the transverse colon in a child: a case report. 1277 50

Among Gastrointestinal Duplications, colonic duplications are the less common. The case presented here consist of a duplication of the transverse colon, difficult to diagnose, which had abdominal distension as the main symptom. A 4-year-old child was referred to the Unity of Pediatric Surgery, Hospital de Base, Brasilia, DF with a history of progressive abdominal distension. Plain X-Rays of the abdomen demonstrated a large fecaloma, which demanded removal. A Barium Enema was done suggesting Congenital Megacolon. A rectal biopsy was performed under general anesthesia, demonstrating normal ganglion cells. Medical treatment was instituted for chronic constipation in the Pediatric Gastroenterology clinic. The patient returned three months later with the same complaints. A new rectal biopsy was done; normal ganglion cells were described, ruling out Hirschsprung's disease. The parents were told to insist on the medical treatment diets. Four years later the patient was seen in the Emergency Room with signs and symptoms of low intestinal obstruction. Exploratory Laparotomy was undertaken as an emergency and the findings were complete volvulus of the large bowel involving the transverse colon up to the splenic flexure, demonstrating a large duplication of the transverse colon. A resection of the duplication and end-to-end colonic anastomosis was performed with an uneventful postoperative care. Discharged on excellent conditions.
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PMID:[Tubular duplication of the colon: a case report and review of the literature]. 1468 38

Sigmoid volvulus is the third most common cause of colonic obstruction in the United States after cancer and diverticulitis. Etiologic factors include anatomic variation, chronic constipation, neurologic disease, and megacolon. Management of sigmoid volvulus involves relief of obstruction and the prevention of recurrent attacks; the outcome depends on the population and selection of patients. Although volvulus is uncommon, it may be encountered during pregnancy and is a condition that poses significant risk to both mother and fetus requiring a management strategy that varies with each trimester.
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PMID:Sigmoid volvulus an update. 1654 32


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