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PubMed1950

Hallux valgus.

Explore the source record for details and available documents.

Digestive System Abnormalities↗
PubMedDate not supplied

[Eosinophilic colitis. A report of two cases with non conventional treatment].

Eosinophilic colitis is a rare entity of unknown etiology characterized by diarrhea, abdominal pain, and gastrointestinal bleeding. Diagnosis includes histopathological infiltration of more than 20 eosinophils in colon. It is frequently associated with milk hypersensitivity and, less usual, with other foods and increased IgE. Histopthological appearance of eosinophil mediators has been observed in the gut. It is sometimes related to the degree of infiltration of eosinophils in the gut as well as to the disease severity. There is not an established treatment for this entity, although systemic steroids have been used with certain efficacy. However, there is a recurrence of the symptoms when the therapy stops, besides the well known side effects of the long-term use of steroids. Cromolyn inhibits mast cell degranulation and prevents liberation of mediators. It is successful in certain cases, specially the severe ones. However, it is not available for its use in our country. Ketotifen, as last resource in our patients with bad response to habitual treatment and restriction diet, was used. Although its use is controversial, we consider that stabilizing mast cell membrane with subsequent inhibition of degranulation and recruitment of eosinophils to sites of inflammation, would also restrain histamine liberation and blockage of H1 receptors, which would diminish local damage induced by eosinophils. Nonetheless ketotifen mechanism of action is unknown, our patients improved after treatment with this drug.

Child↗
PubMedDate not supplied

Cecocolic torsion: classification, pathogenesis, and treatment.

Cecocolic torsion is a class of right colon obstruction. Under this heading, the known and the recently identified variants are unified under 1 classification. An algorithm is utilized to trace the pathogenesis of these variants. Recent data, prevailing definitions, and controversies are discussed and resolved. The significance of specific membranes and the blood supply is clarified. New symptoms, clinical and x-ray diagnoses are elucidated. The recommended treatments are outlined.

Algorithms↗
PubMed2006

Ileosigmoid knotting in a young adult in Enugu, Nigeria - a case report.

A 25-year old male student who was seen in the emergency unit of our hospital with symptoms and signs of acute intestinal obstruction of 4 days duration is presented. Following resuscitation, an exploratory laparotomy revealed a long gangrenous jejunoileal segment with its base firmly knotted around the mesentery of the sigmoid colon which was also gangrenous. Resection and primary anastomosis of the small bowel was carried out. Hartmann's colostomy was also done following resection of the sigmoid colon. The features of this uncommon presentation of intestinal obstruction described in the literature as ileosigmoid knotting or compound volvolus are highlighted, with particular note that its recognition, rapid resuscitation and exploration will improve prognosis.

Adult↗
PubMed2006

[Cecum mobility as a cause of ileus].

The authors present a rare case of ileus caused by unusual cecum mobility. The 31-years old female patient was diagnosed ineffectively several times due to abdominal pain. The diagnostics, an attempt of a conservative treatment, along with surgical and postoperative treatment are discussed.

Abdomen, Acute↗
PubMedDate not supplied

[Chagasic megacolon. Treatment by abdominal recto-sigmoidectomy with mechanical colo-rectal termino-lateral anastomosis. Preliminary results].

Abdominal rectosigmoidectomy with end to side colorectal mechanical anastomosis is proposed as a new technique for surgical treatment of Chagasic megacolon. The rectum is sectioned and closed at the level of the peritoneal reflexion. The end of the descending colon is anastomosed to the posterior surface of the rectum, as distal as possible, using the intraluminal stapler (Ethicon CDH33). The final result of the operation is similar to Duhamel-Haddad technique with the advantage of being a one stage operation. Forty-three patients with chagasic megacolon were operated on during the period 1989-1994. Twenty-seven were female and 16 were male with ages ranging from 23 to 76 and a mean of 46.1 years. Results obtained were satisfactory; there were no deaths; only three postoperative complications occurred (6.9%). Only one of these (dehiscence of the rectal cupula) was specific for the proposed technique. The two others were intestinal obstruction, due to volvulus of the small intestine in one case and to adhesions in the other. All complications were managed by surgery. All patients are being followed regularly and up to the present time they report daily bowel movements, passing well-formed stools. There are no complaints of fecal incontinence sexual function or disturbed formation of fecaloma in the rectal stump. The colorectal anastomosis was ample in all patients. Since this is a one stage operation with a low rate of complications, the short hospital stay largely compensates the cost of the mechanical suturing device. Regarding recurrences, a long follow-up period of at least 10 years is necessary to evaluate the real effectiveness of this technique.

Adult↗
PubMed1996

Sigmoid volvulus in pregnancy.

During pregnancy, intestinal obstruction due to sigmoid volvulus is extremely rare. Only 73 cases have been reported. A 24-year-old black woman, gravida 2, para 1, presented during Week 36 of an otherwise uneventful pregnancy, with intermittent abdominal pain and constipation, and no history of nausea, vomiting, fever, chills, previous medical problems, or prior abdominal surgery. Her previous pregnancy was a spontaneous vaginal delivery of a normal full-term neonate. On examination, she was afebrile, with abdominal tenderness. Laboratory studies revealed elevated WBC count of 13,500. She was admitted and given a Fleet enema, with no result or change in abdominal pain. Pain worsened; reexamination of her cervix revealed 3 cm dilation. After Pitocin augmentation, a viable male infant with Apgars of 7 and 9 was delivered. Postpartum, abdominal pain continued, with worsening abdominal distention. Radiograph revealed a massively distended colon. Physical examination 12 hours postdelivery indicated peritonitis. Exploratory laparotomy revealed volvulated, gangernous, massively distended sigmoid colon. The sigmoid colon was resected and Hartmann's colostomy performed. She was discharged on postoperative Day 4. Sigmoid volvulus complicating pregnancy is an uncommon and potentially devastating development that should be suspected with worsening abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity.

Adult↗
PubMed2004

Disorders of intestinal rotation and fixation ("malrotation").

Malrotation with volvulus is one of the true surgical emergencies of childhood. Prompt radiological diagnosis is often paramount to achieving a good outcome. An understanding of the normal and anomalous development of the midgut provides a basis for understanding the pathophysiology and the clinical presentation of malrotation and malrotation complicated by volvulus. In this essay, the radiologic findings of malrotation and volvulus are reviewed and illustrated with particular attention to the child with equivocal imaging findings.

Duodenum↗
PubMed2003

Primary volvulus of the ileum in a preterm infant.

Primary volvulus of the small intestine is rare in neonates. We report a case of primary volvulus of the ileum in a preterm newborn. Vomiting and abdominal distension began 10 hours after birth, followed by hypovolemia, hyponatremia, and acidosis. Plain abdominal radiograph revealed a pattern of diffuse ileus and very dilated loops at the right upper quadrant of the abdomen. Three days later, another plain film showed increased fluid accumulation and decreased air in these dilated loops. Emergency laparotomy revealed primary volvulus of the distal ileum with gangrenous change. Resection of the necrotic ileum with an end-to-end ileoileostomy was performed and the patient recovered fully. In a newborn with ileus and rapidly deteriorating hemodynamics, early surgical intervention is essential to achieve good prognosis.

Female↗
PubMedDate not supplied

[Volvulus of the cecum. A case report].

The authors present one case of intestinal obstruction by volvulus of the cecum. The patient had abdominal pain for 4 days. This pain was colicky in nature and of greatest in density in the left iliac fossa. He was nauseated, had anorexia, and had been vomiting. Abdominal distension was present. Plain-roentgenogram of the abdomen showed an enormously distended gas-filled intestinal loop in the upper abdomen just to the left of midline. At surgery there was volvulus of the cecum located in the upper abdomen to the left of midline. The cecum was viable and was relocated in the right lower quadrant and secured to the antero-lateral abdominal wall (cecopexy). The patient made a good postoperative recovery.

Adult↗
PubMed2004

Small bowel volvulus due to giant mesenteric lipoma.

We report on a 14-year-old girl with acute intestinal obstruction due to volvulus of the small bowel caused by a giant mesenteric lipoma. To the best of our knowledge, this presentation of a mesenteric lipoma is unknown in the previous paediatric literature.

Adolescent↗