PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Intestinal Volvulus”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,513 records · Page 84Linked to original sources
PubMed2000

Epidermal growth factor is critical for intestinal adaptation following small bowel resection.

The loss of small intestinal mucosal surface area is a relatively common clinical situation seen in both the pediatric and adult population. The most frequent causes include mesenteric ischemia, trauma, inflammatory bowel disease, necrotizing enterocolitis, and volvulus. Following surgical resection, the remnant intestine compensates or adapts to the loss of native bowel by increasing its absorptive surface area and functional capacity. Unfortunately, many patients fail to adapt adequately, and are relegated to lifelong intravenous nutrition. Research into intestinal adaptation following small bowel resection (SBR) has evolved only recently from the gross and microscopic level to the biochemical and genetic level. As understanding of this process has increased, numerous therapeutic strategies to augment adaptation have been proposed. Epidermal growth factor (EGF) is an endogenous peptide that is secreted into the gastrointestinal tract and able to influence gut ontogeny, as well as mucosal healing. Early studies have demonstrated its ability to augment the adaptive process. Focusing on a murine model of massive intestinal loss, the morphological, structural, biochemical, and genetic changes that occur during the intestinal adaptive process will be reviewed. The role of EGF and its receptor as critical mediators of the adaptive process will be discussed. Additionally, the ability of EGF to augment intestinal proliferation and diminish programmed cell death (apoptosis) following SBR will be examined. Enhancing adaptation in a controlled manner may allow patients to transition off parenteral nutrition to enteral feeding and, thereby, normalize their lifestyle.

Adaptation, Physiological↗
PubMed1993

Complete small-bowel volvulus complicating the second trimester.

BACKGROUND: Volvulus is the second most common cause of intestinal obstruction in pregnancy. Rarely is the small bowel involved, and even less frequently is the volvulus complete. CASE: The patient was referred at 24 weeks and 4 days' gestation for persistent anorexia, emesis, and abdominal distention. History, physical examination, and abdominal radiographs were consistent with a complete small-bowel obstruction. Laparotomy revealed two adhesive bands, which were lysed, and a 360 degrees volvulus of the small bowel about its mesentery, which was successfully reduced. CONCLUSION: This patient represents a case of complete small-bowel volvulus successfully treated in the second trimester by detorsion.

Adult↗
PubMed2001

[Cecum volvulus--a frequently misdiagnosed disease picture. Results of a retrospective study of 26 patients and review of the literature].

BACKGROUND: Cecal volvulus represents a rare disease which causes acute or chronic intermittent mechanical obstruction. Diagnosis of the acute form of cecal volvulus is often established too late with resulting high morbidity and mortality. This study characterizes the typical clinical symptoms, radiological signs and the frequent concomitant diseases, based on a rather large number of patients. We specifically evaluated possible differences concerning clinical presentation, therapy and postoperative course of patients with vital bowel as opposed to necrotic cecum. PATIENTS AND METHODS: 26 consecutive patients hospitalised with cecal volvulus from January 1984 until February 2000 were retrospectively evaluated. Patients with vital intestine (n = 14) were compared to those with necrotic cecum (n = 12). RESULTS: 38% of patients underwent previous abdominal surgery, 34% suffered from other acute disease, in 38% cecal volvulus was associated with a neuropsychiatric disorder. 58% of the patients showed symptoms of intestinal obstruction. The clinical pattern of patients with necrotic cecum was not significantly different from those of patients with vital intestine. Diagnosis of cecal volvulus could be established in 77% by plain abdominal X-ray alone or by an additional contrast enema. CONCLUSIONS: Knowledge of the characteristic pattern of history, physical findings, plain abdominal X-ray and the frequently with cecal volvulus associated diseases most often allows to establish diagnosis of cecal volvulus without delay and other diagnostic procedures. Astonishingly we found no major difference between vital and necrotic cecum with regard to clinical presentation and postoperative course.

Adult↗
PubMed2002

Portomesenteric vein gas: diagnostic and prognostic value.

Portomesenteric pneumatosis has been traditionally associated with intestinal infarction and poor outcome; however, recent studies have questioned its clinical value. To assess its diagnostic and prognostic significance we have retrospectively evaluated 47 patients correlating the CT finding of portomesenteric vein gas with clinical data and outcome. Thirty-nine patients (83%) had surgical evidence of intestinal infarction, four had necrotic small bowel volvulus (8.5%), two had blunt trauma, one had necrotic gastric volvulus, and one a gastric mucosal lesion induced by a nasogastric tube. Fifteen patients survived (31.9%); only 8/39 patients with intestinal infarction survived. Portomesenteric pneumatosis is a reliable marker of intestinal infarction and poor outcome; however, in trauma patients this sign is associated with a better prognosis.

Journal Article↗
PubMed1994

Colonic volvulus in children: value of barium enema for diagnosis and treatment in 14 children.

OBJECTIVE: Colonic volvulus is a rare type of intestinal obstruction in children. We reviewed our experience in 14 cases to determine the specific portion of the colon involved and the value of barium enema for diagnosis. MATERIALS AND METHODS: We retrospectively reviewed medical and radiologic records of 14 cases of colonic volvulus in children at the Children's Hospital of St. Paul from 1955 to 1992. Both abdominal plain radiographs and barium studies were examined. The children were 3 months to 15 years old. RESULTS: Two cases involved the transverse colon, two were cecal, and 10 occurred in the sigmoid colon. Findings on barium enema indicated colonic volvulus in all 14 children. The barium enema also was successful therapy in 11 of the 14 cases. CONCLUSION: As unusual as colonic volvulus is in children, it should remain in the differential diagnosis of abdominal pain of sudden onset in this age group. Fourteen cases were detected at our institution alone, two of which involved the transverse colon. The barium enema can be used to confirm the diagnosis and frequently is therapeutic.

Barium Sulfate↗
PubMed1997

Primary small bowel volvulus in rural Nepal.

Primary small bowel volvulus is the commonest cause of intestinal obstruction in the Gorkha district of Nepal resulting in laparotomy. Yet, this problem is mentioned only briefly, if at all, in many standard textbooks of surgery. This paper presents details of the presentation, clinical findings, and surgical management of 18 cases of primary small bowel volvulus. Small bowel volvulus occurred in adults only, with an overwhelming male predominance and a low mortality despite late presentation in the majority of cases. Attention is drawn to the common finding of localized ischaemia of several centimetres of terminal ileum.

Adolescent↗
PubMed2006

Use of ultrasonography to diagnose large colon volvulus in horses.

OBJECTIVE: To describe the use of ultrasonography to diagnose large colon volvulus (LCV) in horses. DESIGN: Descriptive report. ANIMALS: 4 horses with clinical signs of abdominal pain. PROCEDURE: Each horse was administered analgesic agents for pain control and placed in stocks. Ultrasonographic evaluations were performed with a 3.5-MHz sector scanning transducer that was placed parallel to the long axis of the horse (longitudinal imaging) over an area of the left ventral aspect of the abdomen. The boundaries of the evaluated region included the ventral midline, 2 vertical lines at the level of the left 10th and 17th intercostal spaces, and a horizontal line between the 2 vertical lines at the level of the costal arch of the left 10th intercostal area. RESULTS: In all horses, nonsacculated large colon was identified ultrasonographically in the left ventral portion of the abdomen; this finding was considered indicative of LCV. In 3 horses, the LCV involved intestinal rotation of 180 degrees, whereas in 1 horse, the LCV involved intestinal rotation of 540 degrees. As confirmed by surgical or postmortem findings, the degree and location of the volvulus were correctly estimated from ultrasonographic images. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, this method of diagnosis of LCV appears to be of value regardless of the location at which the rotation of the large colon occurs. Ultrasonographic findings may aid in the earlier diagnosis of LCV in horses, especially at an early stage of the disease when other clinical signs are equivocal.

Abdominal Pain↗
PubMed2003

Massive gastrointestinal bleeding in infants with ascariasis.

Although infestation with Ascaris lumbricoides causes various intestinal complications, massive gastrointestinal bleeding is rare. The authors report on 2 infants who presented with massive hematemesis. In the first patient, a gastroduodenoscopy was performed. Roundworms were found adhering to an oozing duodenal ulcer. Duodenal perforation occurred after extraction of the parasites. The second case was hematemesis together with peritonitis. Exploration found volvulus and a gangrenous segment of the distal ileum. Both infants previously passed roundworms with their stool. The authors conclude that the intestinal ascariasis can be a cause of massive gastrointestinal bleeding, especially in temperate and tropical countries.

Animals↗
PubMed2001

Neonatal sigmoid volvulus: a complication of anal stenosis.

Sigmoid volvulus is an exceptionally rare cause of intestinal obstruction in neonates. Only 7 cases have been reported in the English and French literature. The authors report a recent case of sigmoid volvulus in a neonate secondary to anal stenosis and review the diagnosis and management of this serious condition. The authors believe that carefully performed radiologic reduction is the preferable alternative to surgical intervention.

Anal Canal↗
PubMedDate not supplied

Neonatal ileoileocolic intussusception associated with ileal polyp: report of one case.

Neonatal intussusception is an uncommon disease. We report a case of neonatal ileoileocolic intussusception led by an ileal polyp in a female neonate. The patient presented with irritable crying, bilious vomiting and frank bloody stool on the 26th day of life. On physical examination, a mobile abdominal mass was palpated. Abdominal sonography demonstrated a long segment intussusception; associated with a low echogenic mass. At laparotomy, ileoileocolic intussusception led by an ileal polyp was found. Pathology confirmed the diagnosis of polyp. Because intestinal obstruction is the primary manifestation, neonatal intussusception is initially indistinguishable from obstructions due to other reasons like intestinal atresia, congenital bands, necrotizing enterocolitis or midgut volvulus. Our experience showed that although uncommon, intussusception should be considered in the differential diagnosis of intestinal obstruction during the newborn period.

Female↗
PubMedDate not supplied

A causal factors and treatment of obstructive ileus in 369 patients.

From 1998 to 2002, 369 patients (47.39% M, 52.61% F; mean age 67.9 yrs) were faced in the Authors' Department due to acute intestinal obstruction. The main reasons of obstruction were adhesions in 281 patients (76.15%), followed by malignant neoplasms of large intestine in 41 patients (11.11%) hernias in 9 patients (2.44%), Ischemic colitis (4.1%), bezoars (2.39%), bile stone (2.71%) and volvulus (1.1%). In this study the clinical and laboratorial investigation, the preoperative preparation and the applied surgical treatment of patients with obstructive ileus are discussed. Also it is stressed the importance of the proper preoperative support, as well as the convenient surgical confrontation of patients.

Adolescent↗
PubMedDate not supplied

Malrotation of the intestine.

Malrotation of the intestinal tract is a product of a well defined aberrant embryology. Because the consequences of malrotation associated with a midgut volvulus may be catastrophic, an understanding of the anatomy, diagnostic criteria, and appropriate therapy for this putative emergency illness is imperative. This report summarizes a recent 18-month experience with this diagnosis and contrasts this experience with that in the published literature. More than half (14/22) of the patients presented during the first month of life, and all had vomiting, which in most cases was bilious. The barium upper gastrointestinal series was the preferred diagnostic study, being both sensitive (18/19, 95%) and accurate (18/21, 86%). In this series two-thirds of the patients presented with volvulus (15/22, 68%) of whom five had ischemic intestine requiring resection. One of these children died of overwhelming sepsis. A Ladd procedure was the preferred treatment, which as defined by us includes evisceration and inspection of the mesenteric root, counterclockwise derotation of a midgut volvulus, lysis of Ladd's bands with straightening of the duodenum along the right abdominal gutter, inversion-ligation appendectomy, and placement of the cecum into the left lower quadrant. A high index of suspicion in the neonate with vomiting, rapid diagnosis, and appropriate operative therapy results in a predictable favorable outcome for children with intestinal malrotation.

Child, Preschool↗
PubMed1980

Cecal volvulus in children.

Volvulus of the cecum is very uncommon in children. Of 189 children operated upon from 1970-1977 for acute intestinal obstruction, in only six children, was cecal volvulus the cause. The etiology and treatment and factors affecting mortality are discussed.

Cecal Diseases↗
PubMed1996

Early sonographic detection of fetal intestinal obstruction and possible diagnostic pitfalls.

We present five fetuses at 15-17 weeks' gestation with a sonographic diagnosis of intestinal obstruction. Dilation of the intestine was the presenting sonographic finding in fetuses with a volvulus and/or anal atresia. Two of the fetuses also had other abnormalities. Intestinal peristalsis may be observed in early pregnancy as transient dilation of intestinal segments. Sonographers are cautioned about a false-positive diagnosis of intestinal obstruction in such cases.

False Positive Reactions↗
PubMedDate not supplied

Adult malrotation: a case report and review of the literature.

Midgut malrotation is an anomaly of fetal intestinal rotation that usually presents in the first month of life. It is rare for malrotation to present in adulthood. Symptomatic patients present either acutely with bowel obstruction and intestinal ischemia with a midgut or cecal volvulus, or chronically with vague abdominal pain. Chronic symptoms can often make the diagnosis difficult. Findings diagnostic of malrotation are described using several modalities such as barium studies, computed tomography (CT) scans, angiography, and often emergent laparotomy. Treatment remains the Ladd procedure originally described by Dr. Ladd in 1936. Complete resolution of acute obstruction or chronic abdominal pain is the result of a high index of suspicion for malrotation, appropriate diagnostic studies, and aggressive definitive surgical treatment. We present a case of malrotation in an adult who presented with chronic abdominal pain. Midgut malrotation is a congenital anomaly referring to either lack of or incomplete rotation of the fetal intestines around the axis of the superior mesenteric artery during fetal development. Most patients present with bilious vomiting in the first month of life because of duodenal obstruction or a volvulus. It is rare for this condition to present in adulthood. The true incidence in adults is difficult to estimate because most patients who remain are asymptomatic and their conditions are, therefore, never diagnosed. A literature review by von Flue et al cites 40 cases from 1923 to 1992. Patients who are symptomatic often present either acutely with bowel obstruction and intestinal ischemia with a midgut or cecal volvulus or chronically with vague abdominal pain. These symptoms are caused by peritoneal bands first described by Ladd in 1932. These bands run from the cecum to the right lateral abdominal wall. We present a case of malrotation in an adult who presented with chronic abdominal pain.

Abdominal Pain↗