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Intestinal volvulus causing obstruction is an unusual complication of ventriculoperitoneal shunts. There are no clear guidelines on the management of this problem. In our patient exteriorization of the shunt with subsequent reinsertion at a different site led to an uneventful recovery. The extreme rarity of this complication and its challenging management are discussed.
Mesenteric lipoma as a cause of small intestinal volvulus has not been reported before. We report a middle-aged man with this entity.
A concept of the aetiology of intestinal volvulus is presented based on the fact that bowel when distended becomes elongated. The antimesenteric border of the bowel elongates more than the mesenteric border and this provides the driving force which initiates and sustains the volvulus. It is, therefore, a secondary event resulting from distention.
Volvulus of the small intestine was diagnosed as a complication of acquired inguinal herniation in 2 horses. One of the horses continued to have signs of pain after reduction of the hernia. The volvulus was diagnosed at a second surgery, but the intestine was devitalized, and the horse was euthanatized. Ventral midline exploratory surgery was performed on the second horse, in conjunction with an inguinal approach. The small-intestinal volvulus was diagnosed and corrected at this time. It is suggested that ventral midline abdominal exploration be performed when acquired inguinal herniation causes acute small-intestinal obstruction in horses.
A case of in utero intestinal volvulus with haemoperitoneum, diagnosed prenatally by ultrasonography is reported. The diagnostic technique enables planning and prompt management of acute abdomen.
A previously well 7-week-old boy was found unresponsive and cyanotic in his cot in the morning. Resuscitative attempts achieved only partial response with subsequent terminal cardiac arrest occurring later in the day. At autopsy a large intestinal volvulus was found associated with disseminated Clostridium perfringens sepsis. In addition, a duplication cyst of the terminal ileum was present. Although rare, right-sided colonic volvulus may be a cause of unexpected death in infancy. While predisposing factors to volvulus may include intestinal duplication cysts, the anatomic relation of the duplication to the volvulus must be carefully determined before a causal relation can be accepted; the cyst in this case was most likely incidental to the terminal event.
Enterocystoplasty complications related to the presence of intestinal mucous presence in the bladder are well known and well reported in the literature. Mechanical problems in the intestinal tract due to using gut for bladder augmentation are not as well recognised. We analyzed three cases of children treated by ileocystoplasty who presented an intestinal volvulus in two cases and a cecal volvulus in one case around the vascular pedicle of the intestinal patch used for bladder augmentation.
The records of nine dogs with intestinal volvulus were reviewed. Most were young adult (median 2.6 years) males (6/9) of medium to large breeds. Vigorous activity, dietary indiscretion, or trauma preceded volvulus. Signs included a peracute to acute onset of vomiting, hematochezia, a moderately distended and often painful abdomen, and shock. Normal packed cell volume, altered white blood cell count, hypoproteinemia, hypoalbuminemia, hypokalemia, pathologic bowel dilatation, and serosanguineous abdominal fluid were common clinical findings. Jejunum was most often affected. One dog survived with surgical management.
A case of intrauterine intestinal volvulus and hemoperitoneum with symptoms of fetal distress at 34 weeks' gestation is presented. The mechanism of production of late decelerations in this setting is discussed.
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UNLABELLED: Volvulus with or without malrotation are infrequent in the extremely premature newborn. CASE REPORTS: Intestinal volvulus in seven premature newborns are reported with abdominal distention, bright and tense skin without visible bowel loops and spiraled bowel loops on the abdominal X-ray. Intestinal resection was avoided due to early diagnosis. We identified abdominal wall massages as a risk factor, because no new cases have occurred since interdiction of these practices. CONCLUSIONS: Symptoms and radiologic findings are relatively specific for excluding the diagnosis of necrotizing enterocolitis in premature newborns. Abdominal nursing could be the incriminating factor.
Midgut volvulus with or without intestinal malrotation can occur in fetal life. Several reports have described congenital midgut volvulus showing non-specific sonographic findings of intestinal obstruction and perforation in utero. None of the previously reported cases, however, were definitively diagnosed as midgut volvulus by fetal sonography. We report two cases both exhibiting the sonographic 'whirlpool' sign, in utero. Color Doppler interrogation provided a clue to the viability of the involved intestinal segment.
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Two boys developed bile-stained vomiting shortly after being involved in significant right-sided blunt trauma and sustaining fractured right femurs. Both had intestinal volvulus and both had a history of bile-stained vomiting in infancy, which had been investigated and interpreted as normal.
An adult female bowhead whale, Balaena mysticetus, from the Beaufort Sea, Alaska (USA), had necrosis of a well-demarcated portion of the mid-jejunum and adjacent mesentery, accompanied by fibrinous peritonitis. The veins within the mesentery adjacent to the affected intestine were severely dilated and hyperemic. There were no perforations of the gastrointestinal tract, nor any thromboses within the mesenteric veins. Death appeared due to the sequelae of intestinal volvulus and infarction; reduction of the displacement presumably occurred during handling of the animal.
The introduction of laparoscopic cholecystectomy has revolutionized the surgical management of biliary diseases. As the application of this procedure becomes more popular, a variety of associated complications have emerged. We present a rare case of a patient who developed an intestinal volvulus 3 days following laparoscopic cholecystectomy. The precipitating factors of this complication and review of literature are discussed.