Malrotación-vólvulo intestinal: hallazgos radiológicos

Gomiz, E. Ballesteros; Ayats, A. Torremadé; Feliubadaló, Carmina Durán; Martínez, C. Martín; Caro, Aleidis

doi:10.1016/j.rx.2014.07.007

Cited by 17 publications

(11 citation statements)

References 41 publications

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“…La rotación intestinal sucede en tres etapas, descritas por primera vez por Frazer y Robbins en 1915 5,6 . Según el momento el que se interrumpe dicha rotación, se producen diferentes tipos de posición intestinal anormal en el abdomen 7,8 .…”

Section: Discussionunclassified

“…El examen de elección para diagnosticar la malrotación intestinal continúa siendo el tránsito intestinal 7,9 , con una sensibilidad del 93 al 100 % y una especificidad cercana al 85 %, aunque la sensibilidad para el diagnóstico de vólvulo es solo del 53 %. El diagnóstico se basa en comprobar la posición anómala de la unión duodeno-yeyuno, desplazada inferior y medialmente.…”

Section: Discussionunclassified

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Malrotación intestinal en adultos: causa infrecuente de obstrucción intestinal

et al. 2019

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La malrotación intestinal es una malformación congénita que afecta hasta al 1 % de la población. Aproximadamente, el 90 % de los casos se presenta en la edad pediátrica y, rara vez, en la población adulta, lo que convierte a esta alteración en un reto para los profesionales sanitarios. Se presenta el caso de una paciente que se inició con un cuadro de obstrucción intestinal y abdomen agudo; se le diagnosticó malrotación intestinal, vólvulo y obstrucción por bridas, durante la laparotomía exploradora urgente. El conocimiento de condición patológica es imprescindible para poder brindarle un correcto tratamiento quirúrgico.

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Section: Discussionunclassified

Malrotación intestinal en adultos: causa infrecuente de obstrucción intestinal

et al. 2019

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“…Diagnosis is mainly conducted with CT scan, upper gastrointestinal examination, or incidental surgical findings [5]. However, radiographic examination is limited to diagnosing the anomaly of the rotation due to false positives and negatives [17, 20, 21]. Operative findings are vital for the final diagnoses of an abnormality.…”

Section: Discussionmentioning

confidence: 99%

The recurrence of colonic volvulus due to nonrotation after intestinal resection in adulthood: a case report

et al. 2019

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BackgroundIntestinal nonrotation is a rare congenital condition that causes fatal colonic volvulus at any age. Once volvulus attack occurs, radical surgical therapy is required for treatment and the prevention of recurrence. This report describes the case of an adult female patient with a recurrence of cecum volvulus due to intestinal nonrotation after transverse colon resection for colonic volvulus.Case presentationA 27-year-old female visited our emergency room (ER) with intermittent abdominal pain and nausea. Enhanced computed tomography (CT) showed enlargement of the level of the ascending and transverse colon and an obstruction with a whirlpool sign at the transverse colon. The small intestine was distributed on the right side of the abdominal cavity, and the large intestine occupied the left side. She was diagnosed with volvulus with intestinal nonrotation, and emergency surgery was performed. Surgical examination indicated that the ascending colon to the transverse colon was not fixed to the retroperitoneum, and the transverse colon was rotated 180° clockwise. The axis of the volvulus was a mesenteric adhesion of the transverse colon. The involved transverse colon was resected, and the intestine was reconstructed by functional end-to-end anastomosis (FEEA). Six years after the initial surgery, the patient presented to the ER with abdominal fullness and lower abdominal pain. Enhanced CT revealed that the cecum, ascending colon, and remaining transverse colon were dilated with an obstruction. The appendix was located in the left upper abdominal cavity. The clinical diagnosis was cecal volvulus with intestinal nonrotation. An emergency laparotomy revealed that the cecum was rotated 180° clockwise. The terminal ileum to the remaining transverse colon was resected, and FEEA was performed. Seven months later, she suffered obstruction of the intestine caused by an operative adhesion, and conservative treatment was successful. The patient has had no abdominal symptoms for one and a half years so far.ConclusionsSurgeons should realize that nonrotation of the intestines induces volvulus in adulthood and should familiarize themselves with its clinical findings, appropriate treatment, and prognosis. Even after surgical treatment, awareness of the recurrence of volvulus should be maintained to avoid a late diagnosis.

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“…These techniques are currently the most commonly used diagnostic methods because they makes it possible to observe rotation of the intestinal loops and their relationship with the mesenteric vessels and other viscera. 7,8 According to the classic description by Snyder and Chaffin, the primitive midline intestine, rectus and the midline, grows disproportionately compared to the rest of the embryo and determines the U-shaped herniation in the umbilical cord by the sixth week of gestation and the beginning of the 180º rotation process in a counter-clockwise direction on the axis of the superior mesenteric artery (SMA). The latter remains in the duodenojejunal loop to the right, posterior and inferior, and the loop of the colon, to the left and higher.…”

Section: Discussionmentioning

confidence: 99%

Delayed Laparoscopic Cholecystectomy in a Case of Acute Cholecystitis and Intestinal Malrotation Type I

Arias

Ordieres²,

Huergo³

et al. 2019

Clinics and Practice

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In adults, intestinal malrotation is an oligosymptomatic entity that is occasionally discovered during the course of diagnostic studies for other causes. In the case described herein, intestinal malrotation was discovered during investigation for cholelithiasis and acute cholecystitis. Malrotation may occur due to alterations in the asymmetric cellular dynamics of the mesentery responsible for intestinal shortening and unilateral retraction, this may occur as a secondary event following alterations in the expression of homeodomain transcription factors. The incidental finding of asymptomatic intestinal malrotation in adults does not preclude its surgical treatment. However, when intestinal malrotation is associated with cholecystitis, due to cholelithiasis, it is advisable, to first treat the cholecystitis conservatively, in our case, and then perform partial adhesiolysis of the Ladd bands that hinder access to the cystic area and carry out cholecystectomy by elective laparoscopy.

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Malrotación-vólvulo intestinal: hallazgos radiológicos

Cited by 17 publications

References 41 publications

Malrotación intestinal en adultos: causa infrecuente de obstrucción intestinal

Malrotación intestinal en adultos: causa infrecuente de obstrucción intestinal

The recurrence of colonic volvulus due to nonrotation after intestinal resection in adulthood: a case report

Delayed Laparoscopic Cholecystectomy in a Case of Acute Cholecystitis and Intestinal Malrotation Type I

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