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At least 235 records · Page 13Linked to original sources
PubMed1991

[Anesthesia in the patient with stomach dilatation-volvulus].

Before a decision on the anesthetic protocol and the various patient support measures can be taken, the pathophysiological changes that occur during a gastric dilatation-volvulus need to be evaluated. The most important changes are of a circulatory and/or respiratory nature, inducing hypotension, hypovolaemia, cardiac dysrhythmias, a decreased respiratory minute volume, and subsequently resulting in changes in the acid-base balance and plasma electrolyte concentration. In view of these changes and the increased anaesthetic risk for the patient with gastric dilatation-volvulus, the use of barbiturates or ketamine cannot be recommended for anaesthetising these patients. With the use of neurolept-analgesic combinations, such as methadone-droperidol or sufentanil-midazolam, an increased cardiovascular stability and an ample analgesic effect can be obtained. Especially with the potent sufentanil in combination with midazolam, an excellent anaesthesia for patients with gastric dilatation-volvulus can be achieved.

Anesthesia↗
PubMedDate not supplied

[Surgical treatment of paraesophageal hiatal hernia with total intrathoracic volvulus of the stomach].

UNLABELLED: From 1971 to 1993, we operated 44 patients, 34 females and 10 males with a paraoesophageal hernia in which the entire stomach entered the thorax. Mean age of the patients was 70 years. Seventeen patients underwent emergency surgery for strangulated hernia leading to complete ghastric occlusion, gastric bleeding or necrosis (3 cases). Only 2 patients had a past history of gastro-oesophageal reflux. The following techniques were used: abdominal access in all cases, saccular resection, closure of the widened hiatus or of a left sided hernial hiatus, anterior gastropexy suturing the greater curvature to the abdominal on the left. Several patients were in precarious clinical situations and had to be treated under local or regional anaesthesia alone. Two patients had partial necrosis of the stomach and were treated by partial gastropexy. There were no deaths or major complications. Incomplete recurrence was noted in one patient 2 years after the initial procedure. IN CONCLUSION: 1) abdominal access is much preferable; 2) an antireflux procedure is only indicated when the patients have signs of gastro-oesophageal reflux; 3) most complications are not due to the hernia itself but to gastric volvulus. Consequently, simple reduction of the hernia followed by anterior gastroplexy under local anaesthesia can give excellent results in patients in precarious clinical situations and argues against major operation with general anaesthesia; 4) due to the gravity of paraesophageal hernia, a surgical solution is required as soon as diagnosis has been confirmed.

Adult↗
PubMed1991

[Stomach dilatation-volvulus in the dog: current viewpoint and retrospective study in 160 patients].

Diagnosis and treatment of gastric dilatation-volvulus syndrome in the dog are described. A comparison of results obtained between 1984 and 1990 with results from 1977 to 1982 shows a significant decrease in mortality from 63% to 29%, and in the recurrence rate from 82% to 15%. Mortality in patients in which the stomach was decompressed before referral did not differ from that in patients in which decompression was not performed. Two methods of fixation of the pyloric antrum to the abdominal wall are compared. Complications and recurrence rates after tube gastrostomy do not differ significantly from those after gastropexy. The common opinion that dilatation precedes volvulus is rejected. A new hypothesis is proposed, in which volvulus precedes dilatation.

Algorithms↗
PubMed1977

Intermittent dislocation of the liver. A syndrome associated with volvulus of the transverse colon and stomach and obstructive jaundice.

Displacement of the right lobe of the liver into the left upper abdominal quadrant can occur only if the diaphragmatic attachments are congenitally absent or traumatically disrupted. To our knowledge, the former situation has not been previously described in an adult patient. A young man with a lifelong history of unexplained intermittent, bizarre upper abdominal pain was found to have a freely movable right lobe of the liver that was attached only to the inferior vena cava. When this lobe was intermittently displaced into the left upper abdomen, volvuli of both the stomach and transverse colon developed. Stretching and tension of the common bile duct on the round ligament resulted in intermittent jaundice. At operation, these findings were confirmed, and the right liver lobe was secured to the diaphragm in its normal position. In addition, the mesenteric attachments of the liver, stomach, and colon were plicated. The patient has had complete relief of all symptoms for the two years since his operation.

Adult↗