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PubMed1989

[Second-look surgery in ischemic volvulus of the small intestine].

A case of volvulus of the small intestine in a child is reported. At the primary exploration, a segment of the small intestine measuring 240 cm was found to be clinically devitalized. Repeated exploration three days later revealed 90 cm of gangrenous intestine with distinct delimitation from the vital intestine. A second look operation may thus limit intestinal resection in cases of extensive ischaemia of the intestine and indefinite delimitation of the devitalized intestine.

Gangrene↗
PubMed1998

[The diagnostic contribution of computed tomography in a case of volvulus of the small intestine after an ileoanal anastomosis].

A case of acquired volvulus as a cause of late small bowel obstruction, in a patient who had undergone a colectomy with ileal pouch-anal anastomosis two years previously, is described. Computed Tomography (CT) accurately demonstrated signs of adhesive strangulating obstruction, detecting also a radial disposition of the loops around the mesenteric root and an abnormal position of the superior mesenteric artery and vein on the right side of the aorta. From a literature survey, there are no previous studies reporting the CT appearance of a small intestine volvulus developed as a complication of an ileal pouch-anal anastomosis.

Adenomatous Polyposis Coli↗
PubMed1990

Displacement of the large colon associated with nonsurgical correction of large-colon entrapment in the renosplenic space in a mare.

Nonsurgical correction of a renosplenic entrapment of the large colon was attempted in a mare, using a rolling technique. After correction, the mare had initial improvement in clinical signs, but later developed signs of abdominal discomfort. A ventral midline celiotomy was performed, and a pelvic flexure impaction and large intestinal volvulus were found and corrected.

Animals↗
PubMed1996

A complication of mesenteric lymphangioma: case report and brief review of literature.

Mesenteric lymphangioma (ML) has only rarely been reported in the literature. These cases are rare enough to arouse interest when encountered. Usually, the cases are asymptomatic but may present with acute or chronic intestinal obstruction. We report an additional case of ML associated with intermittent intestinal volvulus in a 5 years old boy.

Child, Preschool↗
PubMed1998

Torsion of a Meckel's diverticulum: sonographic findings.

There are few reports of the sonographic appearance of Meckel's diverticulum. We present a case of torsion of a Meckel's diverticulum that was suggested by sonography and confirmed pathologically. We discuss the sonographic differential diagnosis, which includes acute appendicitis, enteric duplication cyst and intestinal volvulus.

Child, Preschool↗
PubMedDate not supplied

Reasoned diagnostic approach to a case of small bowel obstruction.

The case of a 73-year-old male patient come to the Emergency Department for epigastric pain, vomiting and blocked bowel movement is presented. Plain abdominal X-ray performed on emergency showed marked small bowel distention, and air-fluid levels suggestive of intestinal obstruction. CT was indicated to establish its precise site and cause. The presence of a gallstone was evidenced: gallstone ileus was diagnosed. Interestingly enough, at surgery the gallstone was not found; most likely it was expelled spontaneuously during the time elapsed between CT and surgery. Based on imaging findings and a review of the literature it was concluded that the study patient had a rare association of intestinal volvulus and gallstone ileus.

Aged↗
PubMed2000

Enterocystoplasty complications in children. A study of 30 cases.

BACKGROUND/PURPOSE: Bladder augmentation for small vesical capacity represents an important aid to these patients, but the appearance of complications is not rare. We analysed the complications of the enterocystoplasty techniques used in our Department. METHODS: From 1983 to 1997 sixteen girls and fourteen boys were treated. We performed 28 bladder augmentations (in 13 cases using small bowel, in one case using ileum and caecum and in 14 cases using sigmoid colon) and 2 bladder substitutions (in one case with ileum and sigmoid colon and in the second using a colonic segment). RESULTS: Twelve children present recurrent urinary infections. In five children bladder stones were formed (among them a case of familial cystinuria-lysinuria). Two children presented intestinal volvulus and another one a caecal volvulus. In two children a perforation of the augmented bladder was treated operatively. An 11-years-old child presented severe electrolyte disturbances. CONCLUSIONS: The complications presented in our patients confirm the view that they are associated with intestinal mucosa in the bladder and our study proves, once more, the current necessity to seek alternative tissues for bladder augmentation.

Adolescent↗
PubMed1994

[Intestinal obstruction. The experience of the Emergency Service of S. José Hospital 1981-1991].

The results of 3679 patients, with intestinal obstruction, submitted to emergency surgery at the UUC-HCL between November 1981 and November 1991, were analysed in a general way, with the use of a graphic presentation. In the mechanical group, hernia (1604 cases), adhesions and bands (568 cases) and cancer (713 cases) were the most common pathologies; intestinal ischaemia (143 cases) was the most frequent form in the neurogenic group. Surgical therapy was evaluated in a general way. However, we comment on the evolution of primary surgical treatment of colorectal cancer in obstruction (625 cases). The mortality rate was in general: 10.8% (adults). In relative terms, the main features were intestinal ischaemia (39%), cancer (23%) and intestinal volvulus (22%).

Adolescent↗
PubMed1999

Fetal midgut volvulus presenting at term.

This report describes a rare case of intrauterine midgut volvulus that presented at term. The pregnancy was uncomplicated. There were no signs of fetal distress or polyhydramnios, and the child was delivered vaginally. This patient had the unusual presentation in that at the time of delivery, the patient was distended and acidotic. She immediately required an extensive resection of gangrenous small bowel. Comparing this case to the 10 other cases of fetal intestinal volvulus that have been reported, it seems this child was particularly fortunate that the volvulus occurred at a point in gestation when she was mature enough to tolerate birth and surgery. This case is also the first demonstration that volvulus can present with abdominal distension in the immediate newborn period.

Delivery, Obstetric↗
PubMed1981

Origin an importance of increased alkaline phosphatase activity in peritoneal fluids of horses with colic.

The origin of increased alkaline phosphatase (ALP) activity in peritoneal fluid (PF) of horses with clinical signs of abdominal pain was investigated to determine the usefulness of measuring ALP in PF in the diagnosis of small intestinal injury. The ALP isoenzymes in PF from 10 clinically normal horses and from 50 horses with clinical signs of acute abdominal pain were analyzed for their sensitivities to inhibition by L-phenylalanine, L-homoarginine, and levamisole and to inactivation by heat (56 C, 15 minutes). The enzymes also were discriminated by their patterns of migration during polyacrylamide gel disc electrophoresis. Of 50 horses with colic, 20 had ALP activity in PF at least 3 times the upper limit of normal. Of these 20 horses, 10 had marked increases of ALP activity in PF ranging from 10 to 150 times the mean value of activity as determined in the 10 normal horses. In the 50 horses with colic, ALP values in serum were within the normal range. In 19 of the 20 sick horses, the ALP in PF had properties different from small intestinal ALP. Of the 10 PF samples with markedly increased ALP activity, 9 had a group of properties that were unique for granulocytic ALP. The clinical diagnoses for the 10 horses with markedly increased ALP activity in PF included thromboembolic colic (4 horses), colonic torsion (2 horses), small intestinal volvulus (2 horses), peritonitis (1 horse), and salmonellosis (1 horse). Properties of the enzyme in the 10 PF samples with moderately increased ALP activity were compatible with a granulocytic origin, but insufficient enzyme concentration precluded electrophoretic confirmation of the source. The PF from 1 horse had a mixture of ALP isoenzymes derived from granulocytes and small intestinal mucosa. Of the 50 horses with colic, 6 had severe small intestinal disease without increased ALP activity in PF. Apparently, increased ALP activity in PF cannot be used as a reliable indicator of small intestinal injury in horses, because the ALP is predominantly granulocytic in origin.

Alkaline Phosphatase↗
PubMed2006

[D-lactic acidosis in an 11-year-old patient with short bowel syndrome].

The short bowel syndrome is the result of a congenital or acquired loss of a large part of the small intestine. The most frequent causes of surgical resection of the intestine in infants are arterial or venous thrombosis, intestinal volvulus, necrotizing enterocolitis, and Crohn's disease. Symptoms include nutrient and electrolyte malabsorption, steatorrhea and diarrhea, which can result in failure to thrive. The consequences of extensive small bowel resections consist of nutritional deficiencies, gastric acid hypersecretion, nephrolithiasis, cholelithiasis and lactic acidosis. Of these, D-lactic acidosis is an infrequent but important complication because of the symptoms that it can produce. D-lactic acid in the human organism is generated by intestinal bacteria, D-lactate ingestion, or endogenous production in the methyl glycoxylase pathway. Neurological symptoms such as somnolence, ataxia or altered behavior in a patient with short bowel syndrome should make us think of D-lactic acidosis caused by bacterial overgrowth. We present the case of an 11-year-old boy with short bowel syndrome secondary to multiple resections during the postnatal period who was admitted to hospital for episodes of confusion and altered behavior. The diagnosis was lactic acidosis. Outcome was favorable due to prompt instauration of treatment.

Acidosis, Lactic↗
PubMed2003

[Ileo-ileal and ileocecal invagination due to intestinal lipomatosis].

Intestinal lipomatosis is a rare entity and few cases have been reported in the literature. The condition is usually asymptomatic. Symptomatic cases usually present as obstruction or, less frequently, as bleeding. Intestinal barium studies, ultrasonography and computed tomography are useful diagnostic techniques. We present the case of a 47-year-old man with no relevant medical history who presented with intestinal obstruction of several months' duration. Complementary investigations yielded a diagnosis of intestinal obstruction due to ileocecal invagination secondary to endoluminal tumors of the ileum. Surgery and pathological analysis revealed the latter to be intestinal lipomatosis. This rare clinical entity has been associated with diverticulosis and intestinal volvulus.

Digestive System Surgical Procedures↗
PubMed1992

Hydatid disease in a horse.

During routine necropsy of a 28-year-old horse with intestinal volvulus, numerous hydatid cysts were discovered in the liver. Viable protoscolices of Echinococcus granulosus were obtained from the cyst. As a 4-year-old, this horse had been imported from an area that is enzootic for equine hydatidosis.

Animals↗
PubMed1993

[Postoperative obstructions].

The intestinal obstructions after a laparotomy in adult may be caused by an inflammatory or a mechanic pathology; the incidence of the bowel obstruction in the early postoperative period is about 0.5 to 2% of all surgical procedures; these obstructions are often related to the degree of contamination or infection; contrary to postoperative paralytic ileus, they result in a reoperation, so as a peritonitis may be associated. In the later postoperative period intestinal obstructions may be caused by adhesions, internal strangulation or fibrosis bridles; these obstructions are frequent and they affect especially the small intestine (5% of laparotomies will be complicated by small bowel obstruction). The intestine volvulus due to bridles or adhesions is observed in approximately 10% of cases and the diagnosis must be conjured up in principle because it necessities an operation immediately; it's the same for the strangulation by incarceration. The absence of classic indicators of gangrene permits a non-operative treatment using a naso-gastric tube decompression during 24 to 48 hours: generally the causes of obstruction are small bowel adhesions, nevertheless it's important to eliminate a colonic obstruction. The management of chronic postoperative adherences is a difficult problem because the iterative operations increase the risk of intestinal obstructions; the video-laparoscopic surgery seems to be a promising technique to prevent and to treat (laparoscopic adhesiolysis) the post-operative adherences; its results are not evaluated.

Humans↗