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

We have reviewed the records of 48 patients who had colonic volvulus. Volvulus occurred in the sigmoid colon in 27 (56%) and in the right colon in 19 (40%). Volvulus elsewhere in the colon is rare, requiring unusual anatomic circumstances of a long mesentery and a mobile colon. The clinical history is characterized by a long history of bowel dysfunction followed by an episode of acute intestinal obstruction. The patient is often aged and is plagued by mental disorders and a number of degenerative diseases. Distention of the abdomen is the most significant finding, and tenderness may indicate peritonitis due to ischemic changes in the bowel. Three-positional films of the abdomen are most valuable, showing great distention of the colon and air-fluid levels in the bowel with regularity. Barium-enema studies will more accurately reveal the site and nature of obstruction. The barium-enema examination must be done carefully. It is omitted when peritonitis is present. Operative treatment is necessary for volvulus of the right colon. Non-operative reduction is effective for nonstrangulating volvulus of the sigmoid colon as an emergency procedure. Sigmoidoscopic examination and insertion of a long rubber tube will give dramatic relief to a substantial number of patients. Operative intervention is necessary when conservative measures fail. When gangrene is found at operation, exteriorization resection of the colon may be life-saving. Elective resections are recommended for patients who are in otherwise good health in order to prevent recurrences. The mortality rate in this series of 48 cases was 12.5 per cent. Cecal volvulus was present in each of the six patients who died. Sepsis and cardiopulmonary diseases were common in patients who died.
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PMID:Volvulus of the colon. 86 92

The clinical presentation and treatment of 31 consecutive patients with sigmoid volvulus are reviewed. Nearly half of these patients had a history of mental illness and one-third of all patients were chronically constipated. The main clinical features of abdominal pain and gross abdominal distension had been present for an average of 8 days before presentation of the patient to hospital. The clinical diagnosis of sigmoid volvulus was not difficult but the presence of non-viable bowel was more difficult to establish. A silent abdomen was the most valuable indication of the presence of gangrenous bowel. Conservative measures, including sigmoidoscopy and therapeutic barium enema, successfully reduced the volvulus in half of the cases so treated. In those patients undergoing surgery the procedure associated with the lowest mortality was sigmoid resection with end-to-end anastomosis. The overall mortality was 35%.
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PMID:Volvulus of the sigmoid colon. 89 Feb 83

We describe a patient with symptomatic multiple lipomas with volvulus. He complained of gradually increased abdominal pain and distention. Preoperative roentgenograms showed many rounded filling defects of the small intestine. Operation was performed to reduce intestinal obstruction and ileal resection was performed. The dilated ileum was rotated 720 degree clockwise and it contained 115 submucosal and 26 subserosal lipomas. Histologically, the lipomas were benign and consisted of well-developed fat tissue. The patient's postoperative course was satisfactory, and neither residual lipoma nor recurrence were found at barium enema examination two years after operation.
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PMID:Multiple lipomas of the ileum with volvulus. 90 Nov 89

A patient with recurrent sigmoidal volvulus who was treated by elective sigmoidal resection is reported. The symptoms and radiologic findings are sufficient for a confident diagnosis to be made before the onset of a major obstructive epidose. The value of barium-enema examination even in the quiescent phase is emphasized. Definitive treatment by sigmoidal resection in the absence of obstruction is safe and should be undertaken as an elective measure. Awareness of the disease and its occurrence in young patients will aid its recognition and reduce mortality from intestinal obstruction.
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PMID:Elective resection for recurrent sigmoidal volvulus: report of a case. 97 31

A 59 year old man presented with subacute abdominal distension and diarrhea. Plain radiographs and barium enema demonstrated organo-axial volvulus of the sigmoid colon. The radiologic, surgical, and pathologic findings are presented. The radiologic differences between organo-axial volvulus and the common mesentero-axial volvulus of the sigmoid colon are discussed.
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PMID:Organo-axial volvulus of the sigmoid colon. 129 96

A retrospective study of 37 case reports of patients with volvulus of the colon was carried out to define diagnostic and therapeutic strategies. The group comprised 22 men and 15 women, mean age 69 +/- 4 years (range 26-88 years), the volvulus being located in the sigmoid colon (n = 23), ascending colon (n = 13) or transverse colon (n = 1). The diagnosis, suggested by the straight abdominal film in almost all cases, was confirmed by a barium enema in 70% of cases. Treatment was surgical in 30 patients (81%) including 12 as emergency operations. Mortality was 5.4% (2 cases), and morbidity high (43% including fatal complications) the majority of adverse reactions being respiratory. Volvulus of the ascending colon was treated by hemicolectomy in 9 cases with no mortality or relapse. In patients with sigmoid volvulus, a "medical" reduction was performed in 7 patients, with success in 5 cases, one recurrence and no mortality, ideal sigmoidectomies in 14 cases resulting in one recurrence and no mortality. Right hemicolectomy appears to be the technique of choice even for urgent cases, there being no contraindications to a one-stage re-establishment of continuity. Inversely, an urgent intervention should at all costs be avoided in cases of sigmoid volvulus, a "medical" reduction (radiology, intubation, endoscopy) allowing preparation of the patient for a deferred ideal sigmoidectomy. Obviously, failure to reduce the volvulus or signs of colon necrosis require urgent surgery and raise the problem of whether or not to re-establish colon continuity.
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PMID:[Volvulus of the colon. Apropos of 37 cases]. 129 67

There have been efforts to develop an ideal method of intestinal anastomosis throughout medical history. In ancient China, Egypt and India living ants were used to approximate the transected edges of bowel. Many other devices and techniques have since been introduced, using organic or synthetic, nonabsorable or absorbable materials. Lately mechanical stapling devices have become exceedingly popular. The recently introduced biofragmentable anastomotic ring (BAR) is composed of an absorbable polyglycolic acid in 12.5% barium sulfate suspension to permit x-ray visualization. Prospective randomized studies have shown it to be both effective and safe as compared to conventional handsutured or stapled anastomosis. Its main advantages are simplicity and ease of handing, short operating time and the absence of foreign bodies at the anastomotic site that might interfere with imaging methods, such as CT or MRI. We present our preliminary, satisfactory experience with BAR in 14 patients with a mean age of 67 years. 8 underwent right colectomy, 2 left colectomy, 1 sigmoidectomy, 2 resection of upper rectum, 1 subtotal colectomy, 1 excision of a giant lymphoma of the cecum, and 1 had had recurrent bouts of volvulus of the sigmoid.
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PMID:[Sutureless intestinal anastomosis with a biofragmentable anastomotic ring]. 133 33

The case of a 56 year old female with intermittent pain, weight loss, anaemia, and a palpable tympanic abdominal mass is reported. Barium enema showed a very redundant loop of proximal colon, which was thought to have undergone recurrent volvulus. At colonoscopy, the findings seemed normal, but a much shorter length of colon was intubated to the caecum than expected from the barium findings. The duplicated colon was discovered only intra-operatively. This unusual diagnosis should be considered when a barium enema shows a long redundant colon which is not confirmed on colonoscopy.
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PMID:Duplication of the proximal colon mimicking volvulus: a case report. 145 13

We report an unusual complication following vagotomy and pyloroplasty for chronic gastric outlet obstruction. Persistence of increased gastric aspirate led to the diagnosis of organoaxial volvulus of the stomach on barium studies. We postulate that laxity of the gastric suspensory ligaments after gastric decompression and postoperative adhesion were responsible for its development.
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PMID:Organoaxial volvulus of the stomach following corrective surgery for gastric outlet obstruction. 150 54

We report on 2 sisters with congenital midgut volvulus. Both had similar facial changes different from those of their parents and the other 2 unaffected sibs. Both parents had normal barium meal roentgenograms. The occurrence of these abnormalities in sibs born to parents with apparently normal gastrointestinal tract anatomy suggest autosomal recessive inheritance, although a coincidence, multifactorial or autosomal dominant inheritance with nonpenetrance in either of the parents cannot be excluded.
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PMID:Familial intestinal malrotation with midgut volvulus and facial anomalies: a disorder involving a gene controlling the normal gut rotation? 151 49


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