Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042961 (volvulus)
 4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

The discovery at autopsy or at a death scene of fresh perianal hemorrhage and/or cutaneous excoriation in a young child is always of concern as this raises the possibility of inflicted injury. Three cases are reported where perianal bleeding and excoriation that were initially considered due to possible sexual assault were subsequently found to be of a non-suspicious nature. Case 1: A previously well 18-month-old boy was accidentally hanged. Fresh perianal hemorrhage that had raised the possibility of sexual assault was subsequently shown to be due to perineal streptococcal dermatitis. Case 2: A 2-year-old girl vomited and then stopped breathing. Fresh blood at the anus, that was also thought to be patulous, raised suspicions of sexual assault. At autopsy, however, bleeding around the normally configured anus was due to a midgut volvulus associated with intestinal malrotation. Case 3: A 21-month-old girl was found dead in her cot. Sexual abuse was suspected when lacerations were allegedly found around her anus. These were, however, due to skin lesions from her previously diagnosed ectodermal dysplasia clefting syndrome. Death was due to upper airway obstruction from acute and chronic inflammation. There was no evidence of anogenital trauma or sexual assault in any of the cases. Although inflicted traumatic causes of perianal hemorrhage and excoriation must be judiciously sought in the young, the current cases demonstrate that organic etiologies must also be considered. Perianal infections, congenital malformations of the mesentery and intestines, and inherited disorders of the skin may all produce findings that may initially suggest that sexual assault has occurred. Careful examination with appropriate photography and/or microbiological testing are required.
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PMID:Non-traumatic causes of perianal hemorrhage and excoriation in the young. 1929 54

Ehlers-Danlos syndrome, hypermobility type (EDS-HT) is unexpectedly common and is associated with a high rate of gastrointestinal manifestations. We herein report the first documented case of mobile cecum associated with EDS-HT. A 21-year-old woman with repeated right lower abdominal pain was initially diagnosed with EDS-HT. Abdominal examinations performed in the supine position, such as CT and ultrasonography, showed no gross abnormalities. In contrast, oral barium gastrointestinal transit X-ray images obtained with changes in the patient's body position revealed position-dependent cecal volvulus with mobile cecum. She was finally discharged with a dramatic resolution of her symptoms after laparoscopic cecopexy for mobile cecum.
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PMID:Mobile Cecum in a Young Woman with Ehlers-Danlos Syndrome Hypermobility type: A Case Report and Review of the Literature. 2892 24