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

We reviewed a 30-year experience in management of 129 patients with 163 acute obstructions due to sigmoid volvulus. Recurrent obstruction of the colon was observed in 47 (or 45%) of 104 patients who survived their initial obstructive episode: 61% after rectal tube insertion, 45% after detorsion, 33% after sigmoid plication, and 21% despite sigmoid colectomy. Subsequent barium enema or surgical exploration showed true sigmoid volvulus to be the cause of recurrent obstruction in 36 of 47 patients, while atonic bowel, involving the sigmoid alone or more proximal colon as well, was responsible for the other 11 recurrent obstructions. Sigmoid excision was corrective only if bowel atony was limited to that portion of the colon. Only more extensive colectomy, so as to include all flaccid colon, consistently obviated recurrence. Failure to recognize functional obstruction accounted for five of the 25 total deaths.
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PMID:Colonic atony in association with sigmoid volvulus: its role in recurrence of obstructive symptoms. 711 99

A case of non-rotation of the bowel is presented wherein volvulus of the colon occurred causing acute obstruction. Spontaneous reduction following a barium enema as well as the patient's history leads us to suspect that volvulus had occurred in the past and was responsible for the intermittent nature of the patient's symptoms. This type of volvulus is distinctly different from midgut volvulus and is a rare complication of the anomaly of intestinal rotation and fixation known as non-rotation of the bowel. Efforts should be made to study patients with malrotation anomalies at a time when they are acutely symptomatic so that intermittent volvulus such as shown here is not overlooked.
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PMID:Volvulus of the ascending colon: an unusual complication of non-rotation of the midgut. 716 81

Giant Meckel's diverticula are more likely to cause obstruction than bleeding. In neonates, this is commonly due to volvulus; in adults, it is usually due to adhesions and a mass effect. A lateral view of the abdomen following barium studies can be helpful. This entity should be included in the differential diagnosis of intestinal obstruction, especially incomplete, intermittent, and chronic forms.
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PMID:Giant Meckel's diverticulum. A cause of intestinal obstruction. 724 46

In reviewing the records of almost 1000 infants and children with intussusception in two children's hospitals over the last 25 yr, there have been seven bowel perforations during attempted hydrostatic barium enema reduction of an intussusception. Except for one instance, these have all occurred during the last 6 yr. The infants were all 6 mo old or less and most had a preceeding viral illness. Only 4 of the 7 had pain, all vomited, in only 2 was a mass felt and all but 1 had rectal bleeding. The duration of these signs and symptoms was longer than 36 hr with most ill for 3 or 4 days. All seven infants had abdominal x-rays that showed complete small bowel obstruction. Once the intussusception was suspected, barium enema reduction was attempted without excessive hydrostatic pressure and not for a prolonged time; all the ileocolic intussusceptions were met in the transverse colon with only a minimal reduction produced. It was at this time that a perforation was suddenly noted. All infants required immediate right hemicolectomy for the area (s) of colonic necrosis. Postoperatively, there were two wound infections, a volvulus which left the child with a short gut and another infant suffered severe brain damage. These babies seem to fit a pattern in which they are younger and sicker longer than the average infant with an intussusception, and have a complete small bowel obstruction. These facts may be a warning that such infants are at increased risk for a barium enema bowel perforation.
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PMID:Colon perforation during attempted barium enema reduction of intussusception. 725 34

Four pediatric patients with volvulus of the right colon, and three others with twisting of the sigmoid colon are reported. The clinical manifestations, mainly pain, were vague. Radiological plain film findings were occasionally characteristic, but were in the majority of cases equivocal. An active radiological approach including a supplementary barium enema in any patient with inconclusive plain abdominal roentgenograms will, in addition to other unexpected diagnoses, reveal rare cases of large bowel volvulus. Elective surgical procedures, carried out on viable bowel do not necessarily provide advantages over a non-operative approach. In addition spontaneous reduction of the volvulus may result in permanent cure.
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PMID:Large bowel volvulus in children. Review of a case material and the literature. 732 51

Sixteen cases of acute cecal volvulus were retrospectively evaluated. A follow-up was obtained averaging 5.6 years. The average age of the 14 female and two male patients was 47 years. Sixty-two percent of the patients were younger than 50 years of age. Eighty-one percent of the patients had undergone prior operation, with four of these 13 patients having been operated on within the preceding 30 days. Gynecologic procedures accounted for 40% of the previously performed operations. Plain abdominal films and results of barium enema examination were diagnostic or highly suspicious of cecal volvulus. Fourteen nonresectional procedures were performed. No subsequent abdominal operations for recurrence have been required. The concept that this lesion requires resection in the absence of necrosis cannot be supported by our data.
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PMID:Cecal volvulus. A case for nonresectional therapy. 735 82

The radiographs in 10 surgically proven cases of caecal volvulus have been analysed. In the majority of cases of caecal volvulus a plain film diagnosis is suggested by the observation of the haustrated and disproportionately dilated viscus located anywhere in the abdomen. There is often evidence of small intestinal air--fluid distension. Identification of an air-filled appendix attached to the disproportionately dilated viscus provides conclusive plain film evidence of the condition. Difficulties in the diagnosis may be encountered where the caecum is fluid filled and when proximal small intestinal distension obscures the dilated caecum. Barium enema examination provides a definitive pre-operative diagnosis.
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PMID:Further radiological observations in caecal volvulus. 741 50

Two children with small bowel volvulus diagnosed on barium enema examination are reported. In one patient the volvulus was associated with malrotation and in the other patient there was a post-operative peritoneal adhesion. In both cases the diagnosis was based on "beaking" of the head of the barium column at the site of volvulus. Radiographic demonstration of a "beak" sign in the small bowel on barium enema examination should suggest a diagnosis of small bowel volvulus, and indicates the need for immediate surgery.
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PMID:Small bowel volvulus in children: its appearance on the barium enema examination. 745 28

Volvulus of the transverse colon is rare in the pediatric population. We present the tenth known case of a volvulus of the transverse colon in a child. A barium enema demonstrated the bird beak appearance of the colon and showed an air-contrast mirror image in the proximal end. The 360 degrees volvulus found at surgery was treated successfully by detorsion of the bowel.
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PMID:Transverse colon volvulus in pediatric patients. 759 54

Sigmoid volvulus may present in different ways, ranging from a dramatic acute onset to recurrent minor episodes, with symptoms varying in degree of severity in between. In elderly patients and those who already have gangrene of the colon at presentation, the operative morbidity and mortality are high. It has been suggested that perhaps half the patients presenting with acute sigmoid volvulus have a history of previous mild recurrent attacks that have reduced spontaneously. It should be possible to recognise these episodes of subclinical volvulus and to institute treatment before the development of obstruction or possible gangrene. In the 3 cases presented here, features suggestive of subclinical volvulus, viz. abdominal pains, distension, constipation and dramatic passage of flatus are highlighted. Redundant sigmoid colon on barium enema, plus the clinical features mentioned, are virtually diagnostic, and prophylactic surgery is justified to avoid the mortality and morbidity associated with established cases of sigmoid volvulus.
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PMID:Spontaneous untwisting in sigmoid volvulus--the case for 'prophylactic' surgery. A report of 3 cases. 759 3


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