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Midgut volvulus

Keyvan Amini Khoiy, Sophia Abdulhai, Ian C Glenn, Todd A Ponsky, Rouzbeh Amini
Intestinal malrotation places pediatric patients at the risk of midgut volvulus, a complication that can lead to ischemic bowel, short gut syndrome, and even death. Even though the treatments for symptomatic patients of this complication are clear, it is still a challenge to identify asymptomatic patients who are at a higher risk of midgut volvulus and decide on a suitable course of treatment. Development of an accurate computerized model of this intestinal abnormality could help in gaining a better understanding of its integral behavior...
November 11, 2017: Journal of the Mechanical Behavior of Biomedical Materials
Maeghan O'Neill, Jelil Abdel Njouendou, Michael Dzimianski, Erica Burkman, Patrick Chouna Ndongmo, Jonas A Kengne-Ouafo, Samuel Wanji, Andrew Moorhead, Charles D Mackenzie, Timothy G Geary
Flubendazole (FLBZ) is a potent and efficacious macrofilaricide after parenteral administration. Studies in animal models and one trial in patients infected with Onchocerca volvulus revealed that FLBZ elicits minimal effects on microfilariae (mf). Severe complications after ivermectin (IVM) treatment of patients with high Loa loa microfilaraemia are of great concern. We examined the potential of FLBZ to rapidly kill L. loa mf, the phenomenon proposed to underlie the complications. Mf of L. loa were exposed to FLBZ, its reduced metabolite, albendazole, or IVM in vitro...
October 30, 2017: American Journal of Tropical Medicine and Hygiene
Michael Boettcher, Georg Eschenburg, Stefan Mietzsch, Miguel Jiménez-Alcázar, Michaela Klinke, Deirdre Vincent, Bastian Tiemann, Robert Bergholz, Konrad Reinshagen, Tobias A Fuchs
Thrombosis and inflammation cooperate in the development of intestinal infarction. Recent studies suggest that extracellular DNA released by damaged cells or neutrophils in form of extracellular traps (NETs) contributes to organ damage in experimental models of ischemia-reperfusion injury. Here we compared the therapeutic effects of targeting fibrin or extracellular DNA in intestinal infarction after midgut volvulus in rats. Following iatrogenic midgut volvulus induction for 3 hours, we treated animals with a combination of tissue plasminogen activator (tPA) and low molecular weight heparin (LMWH) to target fibrin or with DNase1 to degrade extracellular DNA...
November 13, 2017: Scientific Reports
Wenhua Zhang, Hongjun Sun, Fangqiong Luo
This study is to prospectively evaluate the efficiency of sonography for volvulus diagnosis in neonates with clinically suspected intestinal malrotation.A total of 83 patients with suspected intestinal malrotation who underwent detailed abdominal sonography and upper gastrointestinal contrast study were included. Malrotation was characterized by inversion of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in sonographic examination. The "whirlpool sign" of Color Doppler Sonography was recognized as a characteristic for malrotation with volvulus...
October 2017: Medicine (Baltimore)
Erin P Ward, Andrew Wang, Hari Thangarajah, David Lazar, Stephen Bickler, Timothy Fairbanks, Karen M Kling
INTRODUCTION: Patients with congenital diaphragmatic hernia (CDH), gastroschisis, and omphalocele are prone to abnormalities of intestinal rotation and thus future midgut volvulus. Controversy exists whether routine preemptive Ladd procedure in this subgroup of asymptomatic patients is of value to reduce future volvulus. METHODS: The Pediatric Health Information System (PHIS) database was queried for neonates with CDH, gastroschisis, and omphalocele between January 2009 and September 2015...
December 2017: Journal of Pediatric Surgery
Rahul Gupta, Varsha Soni, Prakash Devidas Valse, Ram Babu Goyal, Arun Kumar Gupta, Praveen Mathur
BACKGROUND: The association of neonatal intestinal obstruction with situs inversus totalis is extremely rare with only few cases reported in the literature to date. This association poses dilemmas in management. We present two such cases (of Indian origin), and briefly discuss the pertinent literature and measures to prevent unfavorable outcome. CASE PRESENTATION: Case 1: a 1-month-old preterm (1300 g) male neonate belonging to Hindu (Indian) ethnicity presented with recurrent bile-stained vomiting, non-passage of stools and epigastric fullness...
September 18, 2017: Journal of Medical Case Reports
A Delgado, A Cejas, D Bangasa
BACKGROUND: Advances in diagnostic techniques and perioperative care have greatly improved the outcome of neonatal surgery. Despite this, disparity still exists in the outcome of neonatal surgery between developed and developing countries. METHOD: We performed a prospective study of neonates admitted and treated due to surgical congenital diseases and other conditions in our hospital from April 2015 to April 2017. RESULTS: There were 19 (28,7%) females and 47 (70,3%) males in this group...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Karadeniz Erdem, Atamanalp Selçuk Sabri
Intestinal malrotation occurs if midgut does not complete or partially completes its 270° counter-clockwise rotation around the superior mesenteric artery during embryologic life. In general, it frequently manifests with vomiting due to duodenal obstruction and volvulus in the initial months of life, and it is very rare to manifest in the adulthood. A 20-year-old male patient who had severe abdominal pain, nausea, vomiting, and distention for one day was evaluated at the emergency department. On abdominal tomography "swirling appearance of structures around the superior mesenteric artery" was reported...
2017: Case Reports in Surgery
Kayla Smith, Patricia Martinez-Quinones, Michael Hawkins
No abstract text is available yet for this article.
August 1, 2017: American Surgeon
Priyanka Tiwari, Darshan Patel, Vimal Dhaduk, Prasanna Kumar Reddy, Jainudeen Khalander Abdul Jameel
Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. Patients may present with symptoms of acute bowel obstruction or chronic abdominal pain. Barium study, Contrast Enhanced Computed Tomography (CECT), Magnetic Resonance Imaging (MRI), diagnostic laparoscopy and sometimes explorative laparotomy are used for diagnosis. Ladd's procedure through the open approach has been the treatment of choice for complete malrotation of midgut, however there are reports on successful outcome for both complete and incomplete malrotation after laparoscopic approach as well...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
Adrian T Fung, David E Konkin, Zaheer S Kanji
We report a case of a 53-year-old male who presented with acute onset right upper quadrant (RUQ) abdominal pain with investigations demonstrating malrotation causing midgut volvulus and subsequent intestinal obstruction. The patient was consented for an emergent operation and underwent an exploratory laparotomy. Operative findings included the presence of adhesive bands in the RUQ (Ladd's Band), volvulus of the mid-portion of the small bowel in a clockwise fashion and multiple intra-abdominal adhesions causing internal hernias...
May 2017: Journal of Surgical Case Reports
Alaa N Alsharief, Christopher Blackmore, Pierre Schmit
We report a case of a 10-month-old girl who presented with a 10-day history of emesis that became bilious on the last day. The initial evaluation suggested small bowel obstruction. An upper gastrointestinal study confirmed the normal location of the duodenojejunal junction with normal rotation and no evidence of midgut volvulus. Ultrasound (US) evaluation demonstrated two intraluminal lesions that do not follow the typical features of solid or cystic lesions. Two rubber balls were found at surgery to be responsible for the small bowel obstruction...
October 2017: Pediatric Radiology
Diana Martins, Paula Sousa, Juliana Pinho, Joana Ruivo, Ricardo Araújo, Eugénia Cancela, António Castanheira, Paula Ministro, Américo Silva
We report a 47-year-old man who underwent endoscopic gastrostomy placement due to feeding refusal and regurgitation. Procedure was unremarkable. Two days later, the patient presented signs of intestinal obstruction. Computed tomography imaging showed a well-positioned gastrostomy tube, small pneumoperitoneum, and small bowel volvulus (SBV) in the upper right abdomen with proximal small bowel dilated loops. Exploratory laparotomy revealed mesenteric torsion, leading to SBV, with no evidence of intestinal malrotation...
2017: ACG Case Reports Journal
Naziha Khen-Dunlop, Sylvie Beaudoin, Blandine Marion, Véronique Rousseau, Agnes Giuseppi, Muriel Nicloux, David Grevent, Laurent J Salomon, Yves Aigrain, Alexandre Lapillonne, Sabine Sarnacki
BACKGROUND: Complete intestinal volvulus is mainly related to congenital anomalies of the so-called intestinal malrotation, whereas segmental volvulus appears as a distinct entity, mostly observed during the perinatal period. Because these two situations are still lumped together, the aim of this study was to describe the particular condition of neonatal segmental volvulus. STUDY DESIGN: We analyzed the circumstances of diagnosis and management of 17 consecutives neonates operated for segmental volvulus more than a 10-year period in a single institution...
March 2017: Journal of Pediatric Surgery
Ahmet Murat Çakmak, Özlem Boybeyi Türer, Gülnur Göllü Bahadir, Bilge Türedi, Ufuk Ateş, Adalet Elçin Yildiz, Gönül Küçük, Ömer Suat Fitöz, Betül Ulukol, Mustafa Kemal Aslan, Tutku Soyer, Hüseyin Dindar
BACKGROUND/AIM: The aim is to evaluate the long-term outcome of asymptomatic patients who underwent surgical correction for midgut volvulus. MATERIALS AND METHODS: Seven patients managed surgically for midgut volvulus in the last 3 years were included. Demographic features, symptoms at presentation, diagnoses, surgical procedures, and complications were recorded. Patients were then contacted for follow-up and evaluation of long-term outcomes. General physical conditions, anthropometric parameters, feeding habits, and defecation histories were evaluated...
April 18, 2017: Turkish Journal of Medical Sciences
Takeshi Kondo, Kazuhiko Terada
No abstract text is available yet for this article.
March 16, 2017: BMJ: British Medical Journal
S Naidoo, F Kimmie, A Bhyat
Midgut malrotation (MMR) is the abnormal rotation of the foetal midgut around the axis of the superior mesenteric artery which in symptomatic neonates requires a Ladd's procedure. We present a rare case of midgut volvulus occurring in a teenager 3 days after observational management of incidentally discovered MMR during laparoscopic appendectomy. A Ladd's procedure was performed and the patient is well at one-year follow up. We suggest prophylactic Ladd's procedure remains the treatment of choice for MMR even when discovered incidentally...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Maria Hukkinen, Reetta Kivisaari, Antti Koivusalo, Mikko P Pakarinen
BACKGROUND: In remains unclear why in some short bowel syndrome (SBS) patients, the remaining small bowel (SB) dilates excessively leading to requirement of tapering surgery. METHODS: Among SBS children, we retrospectively analyzed risk factors for tapering surgery with logistic regression and compared the outcome of operated patients (n=16) to those managed conservatively (n=44) with Cox proportional hazards regression. RESULTS: SBS was caused by necrotizing enterocolitis (NEC) (n=31), SB atresia (SBA) (n=13), midgut volvulus (n=12), or gastroschisis (n=4)...
July 2017: Journal of Pediatric Surgery
Ehsan Shahverdi, Mehdi Morshedi, Maryam Allahverdi Khani, Mohammad Baradaran Jamili, Fatemeh Shafizadeh Barmi
Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient...
2017: Case Reports in Surgery
Artur Sérgio Gião Antunes, Bruno Peixe, Horácio Guerreiro
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
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