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At least 1,027 records · Page 57Linked to original sources
PubMed2003

Laparoscopic sigmoidopexy by extraperitonealization of sigmoid colon for sigmoid volvulus: two cases.

Sigmoid colectomy-open or laparoscopic-has been advocated as the treatment of sigmoid volvulus. This has a higher incidence of morbidity and mortality. We have successfully treated 2 cases of recurrent sigmoid colon volvulus with laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon. Laparoscopic sigmoidopexy by this technique has not been reported before. The first patient was a 20-year-old male and the second was a 72-year-old female. In both patients, initial detorsion of volvulus was achieved by rectal tube. As the colon was nongangrenous, elective laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon was performed 4 days after the detortion. Operative times were 50 minutes and 70 minutes. Both patients were discharged from the hospital on the third postoperative day. There has been no recurrence of volvulus over a period of 6 and 7 months. There were no complications. In conclusion, laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon may become a superior alternative for the treatment of sigmoid volvulus with nongangrenous colon.

Adult↗
PubMed1990

Management of the acute abdomen complicating oral anticoagulation therapy.

Acute abdominal pain in the patient receiving oral anticoagulants poses a difficult diagnostic and therapeutic challenge. We describe two cases of peritonitis requiring laparotomy in anticoagulated patients, and review 49 similar case reports from the world literature. These patients were usually explored for signs of bowel obstruction. At operation, the intestine often appeared infarcted, but pathologic examination commonly revealed intramural hematomata. In contrast, we present microscopic evidence of hemorrhagic cecal infarction complicating oral anticoagulation therapy in one patient. Intramural intestinal hemorrhage is the most common cause of acute abdominal pain in the anticoagulated patient who undergoes laparotomy. In addition to intramural hemorrhage, 14 per cent of patients had coexistent volvulus, appendicitis, intestinal wall disruption or intestinal infarction. We conclude that anticoagulated patients with suspected intramural intestinal hemorrhage may have severe intraabdominal pathology requiring operation. Therefore, operation is mandatory for patients who fail to improve after a short course of expectant management.

Abdomen, Acute↗
PubMed2001

Laparoendoscopic approaches to enteral access.

Access to the stomach for long-term enteral feeding or decompression can be achieved with numerous methods. The methods include laparotomy, gastroscopy, laparoscopy, and fluoroscopy. All methods have been shown to be safe and effective. Percutaneous endoscopic gastrostomy (PEG) was introduced by Ponsky in 1990, and laparoscopic gastrostomy was introduced 10 years later. PEG rapidly replaced open gastrostomy as the method of choice for enteral nutrition. The laparoscopic alternative was ideal for patients who were not candidates for PEG placement. The laparoscopic or laparoendoscopic placement of enteral tubes allows visualization of the intestinal tract to ensure proper tube positioning. Many patients are not candidates for a PEG because of head and neck cancer, esophageal obstruction from stricture or carcinoma, large hiatal hernia, gastric volvulus, overlying intestine or liver, facial trauma with wired mandible, or severe stomatitis secondary to radiation therapy. Lastly, laparoscopy lessens the chance of injury to the surrounding structures, adhesions can be safely lysed, and metastatic or concomitant disease may be identified. This report will review the numerous methods available to the laparoscopic surgeon for gaining access to the stomach or intestine.

Enteral Nutrition↗
PubMedDate not supplied

[The Chilaiditi syndrome and associated volvulus of the transverse colon].

Hepatodiaphragmatic interposition of the colon, known as Chilaiditi's sign, is generally discovered by chance, during an x-ray study for a different cause as its appearance usually lacks symptoms. When the discovery is accompanied by clinical symptoms such as: abdominal pain, nausea, vomiting, constipation, it is known as the Chilaiditi's syndrome. Transverse colon volvulus is a rare entity. The treatment is emergency surgery. The association of Chilaiditi syndrome and transverse colon volvulus is exceptional, the presence of elongation and hypermotility of the colon associated to long mesenterium are common findings in patients with this association. The presence of signs and symptoms compatible with intestinal obstruction in this clinical association, change the conservative medical handling described classically in the Chilaiditi syndrome. Based on the above, the conduct was surgery for the benefit of the patient. We presented the seventh case in the English world medical literature and the first in Peruvian medical literature, in a 17 year old mentally retarded male patient with renal ectopia.

Adolescent↗