Volvulus of the small intestine in India

Gulati, Shilpa; Grover, N. K.; Tagore, N. K.; Taneja, O. P.

doi:10.1016/s0002-9610(73)80017-0

Cited by 32 publications

(17 citation statements)

References 3 publications

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“…Some authors have reported that the outcome depended on the age of the patient and the duration of symptoms. 8 The mortality rate in India has been reported to be 26%, and it was increased for the patients with intestinal necrosis. 8 We performed the operation at 12 hours after the onset of abdominal pain, and segmental resection of the small bowel due to the gangrenous changes of the small bowel was mandatory.…”

Section: Discussionmentioning

confidence: 99%

“…8 The mortality rate in India has been reported to be 26%, and it was increased for the patients with intestinal necrosis. 8 We performed the operation at 12 hours after the onset of abdominal pain, and segmental resection of the small bowel due to the gangrenous changes of the small bowel was mandatory. Fortunately, the postoperative hospital course was smooth as silk and no remarkable surgical complication developed.…”

Section: Discussionmentioning

confidence: 99%

“…The mortality associated with primary small bowel volvulus has been reported to range between 10% and 67%. 7,8 Primary small bowel volvulus in adults is an extremely rare disease entity in Korea. 9 We report here on a case of primary volvulus of the small bowel in an adult who had no history of previous abdominal operation, and the diagnosis was confirmed by diagnostic laparoscopy.…”

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confidence: 99%

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Laparoscopic Management of a Primary Small Bowel Volvulus

Kim¹,

Kim²,

Kim³

et al. 2007

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Primary small bowel volvulus in adults is a very rare condition, and it is defined as torsion of all or a large segment of the small intestine and its mesentery in the absence of any preexisting etiologic factors. Proper management of the patients suffering from a strangulated obstruction depends on making an early and accurate diagnosis. Timely treatment is crucial to prevent gangrene. A 49-year-old man who had a history of previous abdominal surgery was admitted to our hospital with complaints of acute abdominal pain. Simple abdominal x-ray showed multiple dilated loops of small intestine in the mid-abdomen. Enhanced abdominal computed tomography showed the distended small bowel loops and longitudinal tapering of the collapsed bowel loops. We carried out diagnostic laparoscopy to confirm the cause of suspected mechanical ileus. It revealed strangulation of the small bowel at the terminal ileum due to clockwise torsion of the bowel loop. There were no adhesions or congenital anomalies in the peritoneal cavity. The torsional segment was spontaneously reduced with minimal handling, and the strangulated portion was resected. The patient was discharged from hospital on postoperative day 6. Primary small bowel volvulus in adults is a very rare malady; if the diagnosis is uncertain, then diagnostic laparoscopy is a valuable tool for making the definitive diagnosis and administering prompt treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Laparoscopic Management of a Primary Small Bowel Volvulus

Kim¹,

Kim²,

Kim³

et al. 2007

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…In the patients reported in the English-language literature, the outcome depended on the age of the patient and the duration of symptoms. 9 The mortality rate in India has been reported to be 26%, and it was increased in patients with intestinal necrosis. 9 As reported in the Japanese literature, the intestine was resected in 14 patients, while only 1 patient was treated with detorsion ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…9 The mortality rate in India has been reported to be 26%, and it was increased in patients with intestinal necrosis. 9 As reported in the Japanese literature, the intestine was resected in 14 patients, while only 1 patient was treated with detorsion ( Table 2). Five patients (31%) died of multiple organ failure or disseminated intravascular coagulation syndrome.…”

Section: Discussionmentioning

confidence: 99%

Primary volvulus of the small intestine in an adult, and review of 15 other cases from the Japanese literature

Takemura¹,

Iwamoto²,

Goshi³

et al. 2000

J Gastroenterol

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We report case of primary volvulus of the small intestine and review 15 cases from the Japanese literature. A 56-year-old woman, with a history of appendectomy 30 years previously, was admitted with abdominal distension and signs of peritonitis. Abdominal computed tomography (CT) demonstrated a whirl-like pattern of the mesentery, showing the tightly twisted mesentery around the point of torsion. An emergency laparotomy revealed strangulation of the small intestine, from 200 cm anal to the Treitz ligament to 5 cm oral to the terminal ileum, caused by 360 degrees clockwise torsion. There was no adhesion caused by the previous operation nor were there any congenital anomalies. The strangulated intestine was removed and jejunocolonostomy was performed. The patient was discharged from hospital on day 39 after the operation. Primary volvulus of the small intestine was reported to be rare in Japan, but the mortality was 26%. Immediate diagnosis and surgical intervention is essential to achieve a good outcome. A whirl-like pattern of the mesentery is a typical sign of this condition on CT.

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Primary Small Bowel Volvulus

Duke¹,

Yar²

1977

Arch Surg

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A t laparotomy, 2 L of ascites was suctioned out and the entire intraperitoneal small bowel was found to be ischemic. Volvulus of the smallbowel mesentery was the etiologic factor (the 71-yearold patient had a congenital malrotation). The smallbowel mesentery was detorsed in a counterclockwise fashion, resulting in an immediate change from ischemic (purple) bowel to a normal appearance with almost immediate restoration of peristalsis. Adhesiolysis was performed on a band connecting a proximal loop of jejunum, restoring its blood supply. Lysis of bands lateral to the cecum and ascending colon was undertaken. The retrocecal appendix and base of the cecum were above the level of the umbilicus; appendectomy and cecopexy were performed.Small-bowel mesenteric volvulus in patients with congenital malrotation is a rare cause of intestinal ischemia in adults. Midgut volvulus is most commonly seen in neonates, and it is a surgical emergency. Embryologically, malrotation occurs when the fetal midgut returns to the abdominal cavity at about 10 to 12 weeks; normally, there is a 270°counterclockwise rotation, but this is arrested at varying degrees in malrotation. Ladd bands can occur across the duodenum, sometimes resulting in obstruction. 1 On computed tomographic scan, a swirl pattern is often seen. In Figure 1, tissue is seen rotating around the superior mesenteric artery. In Figure 2, a twisting of the small bowel mesentery is demonstrated. Because the location of the appendix is abnormal, appendectomy is performed to prevent future diagnostic uncertainty.In this patient, there is a possibility that her diet contributed to her condition. Duke and Yar 2 reported that there was a "striking increase in the frequency" of primary small-bowel volvulus in Afghani Muslim men during Ramadan. This was hypothesized to be secondary to high fiber intake following fasting.

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Volvulus of the small intestine in India

Cited by 32 publications

References 3 publications

Laparoscopic Management of a Primary Small Bowel Volvulus

Laparoscopic Management of a Primary Small Bowel Volvulus

Primary volvulus of the small intestine in an adult, and review of 15 other cases from the Japanese literature

Primary Small Bowel Volvulus

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