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Results for “Intestinal Volvulus”

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At least 19 recordsLinked to original sources

PubMed1978

Intestinal volvulus: angiographic findings.

Intestinal volvulus may be the underlying process in patients presenting with intestinal ischemia. In 3 patients, angiographic findings of volvulus were erroneously interpreted as indicating occlusive or nonocclusive intestinal ischemia. In a fourth, the correct preoperative diagnosis was suggested by angiographic findings. Volvulus should be suspected at angiography by the whirlpool arrangement of the mesenteric arterial branches, the delayed filling and emptying of the arteries, and the intense opacification of the bowel wall. Familiarity with the angiographic picture of intestinal volvulus is essential for early diagnosis and for prompt initiation of appropriate therapy.

Aged↗

PubMed1963

Intestinal volvulus in idiopathic steatorrhea.

Volvulus of the intestine has recently been observed in three patients with idiopathic steatorrhea in relapse. Two patients gave a history of intermittent abdominal pain, distension and obstipation. Radiographic studies during these attacks revealed obstruction at the level of the sigmoid colon. Reduction under proctoscopic control was achieved in one instance, spontaneous resolution occurring in the other. The third patient presented as a surgical emergency and underwent operative reduction of a small intestinal volvulus. Persistence of diarrhea and weight loss postoperatively led to further investigation and a diagnosis of idiopathic steatorrhea. In all cases, treatment resulted in clinical remission with a coincident disappearance of obstructive intestinal symptoms. The pathogenesis of volvulus in sprue is poorly understood. Atonicity and dilatation of the bowel and stretching of the mesentery likely represent important factors. The symptoms of recurrent abdominal pain and distension in idiopathic steatorrhea necessitate an increased awareness of intestinal volvulus as a complication of this disease.

Abdominal Pain↗

PubMed1995

"Spoke wheel" sign of small intestinal volvulus.

Radiographic diagnosis of small intestinal volvulus and gangrenous change produced by an adhesive band is presented. A soft-tissue mass with radiating mucosal folds simulating a "spoke wheel" was found in the right mid-abdomen. Expansion of the mass was documented on a follow-up radiograph 3 hours later. A "spoke wheel" sign is reported as an early indication of small intestinal volvulus.

Adult↗

PubMed1998

Trend of small intestinal volvulus in north western Ethiopia.

A prospective study was carried out to describe the current incidence, demographic, clinicopathological and radiological characteristics of small intestinal volvulus in comparison with earlier studies. Next to sigmoid volvulus, small intestinal volvulus was the commonest cause of intestinal obstruction presenting with a clinical feature of acute small intestinal obstruction. The primary small intestine volvulus was more common than the secondary one. The typical patient with the primary volvulus of the small intestine was found to be a young adult, male, muscular, farmer, from a rural area whose diet was bulky and mainly made of cereals.

Acute Disease↗

PubMed2001

Small intestinal volvulus in Southern Ethiopia.

BACKGROUND: Small intestinal volvulus (SIV) is a common surgical emergency encountered in many countries. It was reported as the most common cause of intestinal obstruction in the southern part of Ethiopia. OBJECTIVE: This study was intended to evaluate the magnitude and treatment outcome of SIV in a rural hospital. DESIGN: Retrospective study. SETTING: A rural general hospital with 250 beds. SUBJECTS: Ninety eight of 235 patients operated on for acute intestinal obstruction. There were 88 males and 10 females (age range of 16-65 years). INTERVENTION: All patients who were operated on for acute intestinal obstruction during 1992-1996 were included. MAIN OUTCOME MEASURES: Age of patients, duration of the illness and extent of the bowel involved, treatment, and complications were the main outcome measures. RESULTS: Of the 235 patients with acute intestinal obstruction, 98 (41.7%) had SIV. The mean age was 34 years (range 16-65 years). The male to female ratio was 8.8:1.0. SIV occurred mostly among young adults most of whom were farmers. Postoperative complications occurred in 36 cases. The mortality rate was 13.3%, sepsis being the most frequent cause of death. CONCLUSION: Small intestinal volvulus was the leading cause of intestinal obstruction in this series. Early diagnosis and prompt operative intervention minimises the morbidity and mortality rate.

Adolescent↗

PubMed1994

Mesenteric defects as a cause of intestinal volvulus without malrotation and as the possible primary etiology of intestinal atresia.

Mesenteric defects can lead to intestinal volvulus even when the midgut is normally rotated. There are two types of mesenteric defects: basilar, in which the entire base of the mesentery is involved, and segmental, in which only an isolated portion of the mesentery is affected. These defects can present at any age, and the clinical symptoms depend on the extent of the disease and the amount of intestine involved in the volvulus. In the newborn, the basilar defects have clinical signs and symptoms similar to those of midgut volvulus secondary to malrotation. Similar to midgut volvulus secondary to malrotation, this is a surgical emergency. In older patients, basilar defects can be misdiagnosed because of the normal placement of the ligament of Treitz and because of failure to consider mesenteric defects as a possible cause. The treatment for basilar mesenteric defects is intestinal fixation. Intestinal volvulus secondary to segmental defects always presents as intestinal obstruction. In the newborn, these lesions may be indistinguishable from intestinal atresia. Older children present with intestinal obstruction of an unknown cause. Resection of the affected intestine is the treatment for segmental mesenteric defects. Intestinal mesenteric abnormalities as a cause of intestinal atresia unifies under one etiology all the lesions observed in intestinal atresia. Although this theory does not rule out other causes of intestinal atresia, intestinal mesenteric defects may be the primary condition under which intestinal atresia occurs.

Child↗

PubMed1996

The effect of allopurinol pretreatment on intestinal hypoperfusion encountered after correction of intestinal volvulus.

After reversal of blood flow following a prolonged period of ischemia, blood flow returns for a few seconds and is reduced afterward. This is called "no-reflow phenomenon." Antioxidants such as allopurinol have been shown to prevent the occurrence of this phenomenon in organs other than the intestine. An experimental study was conducted to investigate the effect of allopurinol pretreatment on intestinal blood flow after correction of intestinal volvulus in rabbits. In group 1, baseline intestinal blood flow (IBF) was evaluated using radiolabeled red blood cells. In group 2, 720 degrees intestinal volvulus was created and IBF was evaluated 6 hours later. In group 3, intestinal volvulus was created and devolvulus was performed 6 hours later. Intraperitoneal isotonic saline was injected 60 minutes before correction of the volvulus. IBF was evaluated after correction of the volvulus. Group 4 had the same procedures as group 3, but allopurinol (200 mg/kg) was injected in place of the isotonic saline. IBF stopped 6 hours after volvulus. Compared with the baseline group, IBF was significantly lower in the group with volvulus + devolvulus (P < .01). The IBF of the allopurinol-treated group was significantly higher than that of the isotonic saline group (P < .01) and it did not differ significantly from that of the baseline group. Histopathological examination showed that intestinal volvulus leads to histological injury. The histological injury was more pronounced in the devolvulus group and was less severe in the allopurinol group in comparison to the isotonic saline pretreatment group (P < .01). It is concluded that allopurinol pretreatment prevents the intestinal hypoperfusion (no-reflow phenomenon) and histological injury encountered after correction of intestinal volvulus of 6 hours' duration.

Allopurinol↗

PubMed1992

Small intestinal volvulus in adults of Gonder Region, northwestern Ethiopia.

A review of intestinal obstruction in Gonder revealed that small intestinal volvulus in adults is the most common cause of small intestinal obstruction, and it ranked only second to sigmoid volvulus as the most common cause of all intestinal obstruction. Out of 25 patients 23 had primary and the remaining 2 secondary small intestinal volvulus. The secondary small intestinal volvulus occurred in patients both of whom had previous gangrenous sigmoid volvulus that was resected. The disease was predominantly seen in young, adult, male farmers. Though early diagnosis is one of the most important factors in the final outcome of the treatment, the diagnostic accuracy preoperatively is said to be low. In this study diagnosis by exclusion of the common causes of small intestinal obstruction in the region improved the preoperative diagnostic accuracy.

Adolescent↗

PubMed1998

Actinomycotic splenitis and intestinal volvulus in an alpaca (Lama pacos).

Morphologic, microbiologic, and polymerase chain reaction amplification techniques were used to evaluate an alpaca (Lama pacos) with splenitis and intestinal volvulus. The intestinal volvulus produced a severe necrosuppurative typhlocolitis associated with vascular thrombosis and was most likely the cause of death of this animal. In addition, this animal had multiple coalescing abscesses affecting most of the splenic tissue. The isolation of Actinomyces spp. from the spleen and the morphology of the colonies when stained with Gram and Steiner stains support a diagnosis of splenic actinomycosis.

Abscess↗

PubMed1979

Simulated small intestinal volvulus in the anesthetized horse.

Experimental closed loop small intestinal volvulus was studied in the anesthetized horse. Volvulus was simulated by ligation of the mesenterial veins to a segment of small intestine. Physical signs and hemodynamic, hematologic, clinical chemical, bacteriologic and peritoneal fluid values were examined. Compared to conscious horses anesthesia highly delayed and modified the clinical signs of shock (changes in mucosal colour, dehydration, decreased skin temperature, elevated pulse rate, low blood pressures) and of small intestinal volvulus (altered peristalsis, gastric dilation). Plasma glucose response to shock was also modified by unconsciousness. However, a dose response relationship was indicated between the extent of small intestinal damage and clinical symptoms. The same was applicable to changes in blood pressures, blood acid-base balance, lactate, potassium, chloride, glucose, inorganic phosphorus, creatinine, creatine kinase, red blood cell and total white blood cell counts and serum total protein. The relationship was also indicated in the following peritoneal fluid values: volume, lactate, pH, total white cell counts, alkaline phosphatase and bacteriology. Changes related to shock (insufficient tissue perfusion) were low blood pressures and metabolic acidosis due to anaerobic glycolysis with accumulation of lactic acid. Also low plasma glucose and elevated plasma potassium, creatinine, inorganic phosphorus and creatine kinase were regarded as consequences of shock.

Animals↗

PubMed1993

Small-intestinal volvulus in cattle: 35 cases (1967-1992).

Medical records of 35 cattle with small-intestinal volvulus were reviewed. Surgical correction was performed on 32 cattle, and 17 of these cattle were discharged from the hospital. Mean duration of clinical signs for survivors was not significantly different from that for nonsurvivors, and the most commonly recorded clinical signs were abdominal pain, anorexia, lethargy, abdominal distention, and dehydration. Physical examination of cattle with intestinal volvulus revealed tachycardia, tachypnea, and normothermia. Rectal examination findings included distended small intestine, scant feces or mucus, and tight bands coursing dorsoventrally in the middle portion of the abdomen. Clinicopathologic testing revealed azotemia, hypocalcemia, hyperglycemia, and leukocytosis with a left shift. Nonsurvivors had significantly lower mean preoperative venous blood pH and mean base excess and higher mean serum potassium concentration than did survivors. A diagnosis of volvulus of the entire small intestine was made during surgery in 25 cattle, whereas volvulus of the distal jejunum and ileum was diagnosed during surgery in 7 cattle. Survival rate following surgical correction of volvulus of the entire small intestine (44%) was not significantly different from survival rate following surgical correction of volvulus of the distal jejunum and ileum (86%). However, survival rate for dairy cattle (63%) was significantly higher than survival rate for beef cattle (22%). To determine potential risk factors for the development of small-intestinal volvulus, epidemiologic data from cattle admitted to veterinary teaching hospitals throughout North America were collected by searching records entered into the Veterinary Medical Data Base.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2000

Intestinal volvulus: aetiology, morbidity, and mortality in Nigerian children.

In developed countries, intestinal volvulus in children is most frequently due to malrotation. To review the experience in Nigeria, a retrospective analysis of 28 patients managed over 25 years at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, was undertaken. There were 22 boys and 6 girls with an age range of 4 days to 14 years (median 4 years). There were equal numbers over and less than 5 years of age. Vomiting (89%) and abdominal distension (79%) were the most prominent features. Thirteen children (46%) had fever, associated with bowel gangrene in 5, while 8 (29%) presented with severe dehydration and shock. A plain abdominal radiograph was the only investigation performed, but the features were not specific for volvulus. In 11 children (39%) the volvulus was idiopathic, in 9 (32%) due to adhesions or bands, in 5 (18%) to malrotation, and in 1 each a Meckel's diverticulum, internal herniation, and ventriculoperitoneal shunt. Twenty-three patients had a small-bowel, 4 sigmoid, and 1 caecal volvulus. The bowel resection rate for gangrene was 46% (small bowel 9, sigmoid 3, caecum 1). All patients with malrotation had Ladd's procedure performed. Wound infections occurred in 10 patients (36%), complete wound dehiscence in 1, and recurrence in 1 (idiopathic terminal ileal volvulus). The mortality was 21%, mostly from overwhelming infection (2 neonates, 11-year-old, 3 >/= 5 years). Intestinal volvulus in our environment differs in aetiology from other reports. The resection rates are similar, however. This condition carries high morbidity and mortality.

Abdominal Pain↗

PubMed2002

Small intestinal volvulus following laparotomy for endometrial clear cell carcinoma in a woman with a past history of total gastrectomy and Roux-en-Y anastomosis for gastric carcinoma.

BACKGROUND: Small intestinal volvulus is a rare complication following Roux-en-Y anastomosis. CASE REPORT: A 63-year-old woman was diagnosed with small intestinal volvulus following laparotomy for clear cell carcinoma of the endometrium. Her past medical history included a total gastrectomy and antecolic Roux-en-Y anastomosis for Duke's B gastric carcinoma. Operative findings were of transmesenteric herniation of the ileum through the Roux-en-Y small intestinal mesenteric window, with metastatic deposits fixing the hernia at its base to create a volvulus. The proximal transverse colon was very dilated and thin due to partial obstruction by the volvulus. Her treatment involved adhesiolysis and unraveling of the small intestinal volvulus. CONCLUSIONS: This is the first case report of a small intestinal volvulus following a Roux-en-Y anastomosis involving a metastatic gynacological malignancy.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Intestinal volvulus caused by a persistent omphalomesenteric band: report of one case.

Persistent omphalomesenteric band is a rare cause of volvulus or intestinal obstruction. A 7-month-old male infant was brought to this Emergency Room after having shown poor appetite for three days, frequent bilious vomiting, and fever for half a day. Physical examination revealed the infant was dehydrated and had slight abdominal distension as well as hypoactive bowel sounds with a tender, ill-defined mass over right lower quadrant. Radiography and sonography were consistent with distal small bowel obstruction. Emergent laparotomy was done and a fibrous band found extending from the anti-mesenteric border of the ileum to the posterior wall of the umbilicus. Small bowel volvulus had occurred around the band and dilated small bowel was noted. An understanding of the embryologic development of these structures and their normal disappearance may assist pediatricians and surgeons to make the correct diagnosis and select the right pathoanatomic approach in surgery.

Humans↗

PubMedDate not supplied

Factors associated with mortality and morbidity in small intestinal volvulus in horses.

OBJECTIVE: To determine historical, physical, and clinical factors that may affect morbidity and mortality in horses with small intestinal volvulus unrelated to other causes (e.g., incarceration, lipoma, etc.). STUDY DESIGN: Retrospective study. ANIMALS: Client-owned horses (115), aged 1 month to 21 years. METHODS: Data were obtained from medical records, identified by computer search and manual review. Continuous variables were compared between affected and non-affected horses with Mann-Whitney U-tests and non-continuous variables with Fisher's exact test (2 x 2 tables) or chi(2)-tests (larger tables). Stepwise logistic regression analysis was used to develop a multivariable model of the risk factors, taking account of confounding and interaction. RESULTS: Eighty percent of horses recovered from surgery survived to hospital discharge. Neither age, breed, nor sex was related to mortality. Survivors had a significantly lower heart rate, shorter capillary refill time, and better mucous membrane color. Variables associated with worsening cardiovascular status, increased hemoconcentration, and exudation of cells and protein into peritoneal fluid were significantly associated with non-survival. After recovery from surgery, the most serious complication was colic, which was significantly associated with non-survival (P=.028) as was a second celiotomy (P<.01). Both of these complications were associated with a jejunocecostomy during the first surgery. CONCLUSIONS: Significant differences in the clinical and clinicopathologic signs were identified between survivors and non-survivors. CLINICAL RELEVANCE: These findings can be used to make a scientific assessment of prognosis in the pre-operative, operative, and post-operative management of horses with small intestinal volvulus.

Animals↗

PubMed1969

The high incidence of intestinal volvulus in Iran.

The incidence of intestinal volvulus gleaned from the world's medical literature spread over the past seven decades supports the contention that this bowel disorder has distinct geographical predilections. Sigmoid volvulus, invariably superimposed upon a redundancy of this part of the bowel, probably results from a functional disturbance of the colon mediated perhaps by a high-residue vegetable diet. The same factors appear to hold for small bowel volvulus, though caecal volvulus occurs strictly on the basis of preexisting anatomical abnormalities.

Adolescent↗

PubMed1999

Intestinal volvulus in dogs: a study of four clinical cases.

Four cases of intestinal volvulus in German shepherd dogs are described. A definitive diagnosis was achieved by exploratory laparotomy in three cases and after necropsy in the remaining animal. Clinical signs, laboratory investigations and radiological changes are reported for three of the dogs. These dogs were all euthanased. Treatment of complete intestinal volvulus is difficult. By the time the condition is diagnosed, the pathological changes are irreversible, with consequent poor prognosis.

Animals↗

PubMed1995

Management of small intestinal volvulus in a district hospital.

Primary small intestinal volvulus is one of the common causes of intestinal obstruction in various localities of the developing world. Although the general principles of management of intestinal obstruction apply to it, its diagnosis is dependent on a clinical exclusion of other causes of intestinal obstruction with overt features, and awareness of patterns of obstruction in a given locality. Moreover, in nearly all the cases early operation is recommended for a confirmation of the diagnosis and relief of the obstruction. However, lacking the necessary precautions on operation, sometimes a relief of the obstruction without a diagnostic confirmation may be the result.

Adult↗