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Midgut volvulus

Sandip Kumar Rahul, Vijai Datta Upadhyaya, Basant Kumar
Gastrointestinal duplications can affect any part of the alimentary tract and are notorious for their variable presentation. Their association with malrotation and midgut volvulus is rare. We describe an 8-year old boy presented with episodes of abdominal pain. Radiological workup showed whirlpool sign and abnormal relationship of mesenteric vessels. At operation, malrotation with chronic volvulus was found. Incidentally, a jejunal communicating duplication cyst was also noted.
September 2016: APSP Journal of Case Reports
Andrew Grock, Wendy Chan, Ian S deSouza
An otherwise healthy 36-year-old man presented with sudden-onset right upper quadrant abdominal pain and vomiting. A bedside ultrasound, performed to evaluate hepatobiliary pathology, revealed a normal gallbladder but free intraperitoneal fluid. After an expedited CT and emergent explorative laparotomy, the patient was diagnosed with a small bowel obstruction with ischemia secondary to midgut volvulus. Though midgut volvulus is rare in adults, delays in definitive diagnosis and management can result in bowel necrosis...
September 2016: Western Journal of Emergency Medicine
Hidayatullah Hamidi, Yalda Obaidy, Sahar Maroof
A four-day-old boy presented with persistent bilious vomiting, bloody stained stool, and mild abdominal distension. Transabdominal ultrasound demonstrated a round soft-tissue mass-like structure in the right upper quadrant. With color Doppler ultrasound, the whirlpool sign was observed. Abdominal radiograph showed nonspecific findings. Upper gastrointestinal series revealed upper gastrointestinal tract obstruction at the level of distal duodenum. The diagnosis of intestinal malrotation with midgut volvulus was established and the treated surgically...
September 2016: Radiology case reports
Ellen C Benya, Mary R Wyers, Ellen K O'Brien
BACKGROUND: Life-threatening midgut volvulus usually occurs in infants with malrotation and requires rapid diagnosis and surgical treatment to prevent bowel necrosis and death. However, because of the low frequency of upper gastrointestinal studies performed in infants younger than 1 month, many diagnostic radiology residents finish their residency training having limited or no opportunity to perform or observe an upper gastrointestinal (GI) series for evaluation of bilious emesis in a neonate...
August 25, 2016: Pediatric Radiology
Scott Leopold, Mohammed Al-Qaraghouli, Naveed Hussain, Christine Finck
Antenatal midgut volvulus is a rare surgical emergency in which bowel is severely compromised. Rarely the etiology is a mesenteric defect. Early diagnosis is essential and lifesaving in the immediate newborn period. Typically upper gastrointestinal or ultrasound imaging can be suggestive of the diagnosis of volvulus in the neonate. Sometimes, however, the diagnosis may be elusive. Herein, we report on the use of neonatal magnetic resonance imaging to diagnose a midgut volvulus that occurred through a congenital mesenteric defect...
April 2016: American Journal of Perinatology Reports
Alex Ordonez, David Nguyen, Stephanie Mlacker, Andrea Ordonez, Emanuele Lo Menzo, Samuel Szomstein, Raul Rosenthal
A wandering liver is a rare development in both the adult and pediatric population where the liver is freely displaced along a transverse axis. We describe the first known occurrence in published literature of a wandering liver in an adult individual who also had an intestinal malrotation complicated by a midgut volvulus. The abnormal ability for a liver to wander presents a highly unusual anatomy that can be disorienting. Laparoscopic surgery is a viable option in reducing a midgut volvulus and addressing an intestinal malrotation in the presence of a wandering liver...
December 2016: Surgical Case Reports
Ina Jochmans, Jacques Pirenne
A 67-year-old woman with a 6-month history of malabsorption and malnourishment was referred for possible intestinal transplantation. She had a body-mass index (the weight in kilograms divided by the square of the height in meters) of 19. The patient was receiving only parenteral nutrition because..
July 14, 2016: New England Journal of Medicine
Juan Carlos Pelayo, Andrea Lo
Intestinal rotation abnormality (IRA) predisposes to lethal midgut volvulus. An understanding of intestinal development illustrates the process of normal intestinal rotation and fixation. An appreciation of the clinical presentation and consequences of missed IRA will enhance clinical suspicion and timely evaluation. Selecting the appropriate imaging modality to diagnose IRA requires an understanding of the benefits and limitations of each. The Ladd's procedure continues to be the appropriate surgical treatment for IRA with or without volvulus...
July 1, 2016: Pediatric Annals
Christina G Hsu, Abraham Berger, Adina Shulman, Michael Heller, Eric Steinberg
No abstract text is available yet for this article.
September 2016: Journal of Emergency Medicine
Semire Serin Ezer, Pelin Oguzkurt, Abdulkerim Temiz, Emine Ince, Hasan Ozkan Gezer, Senay Demir, Akgun Hicsonmez
BACKGROUNDS: We aimed to evaluate clinical presentation, diagnostic studies, volvulus rate and to emphasize unusual clinical clues in patients who had intestinal malrotation. METHODS: We conducted a retrospective descriptive review on all patients diagnosed with intestinal malrotation between 2002 and 2014. Patients were divided into two groups: Group 1: infants (<1 year, n=16), Group 2: children (>1year, n=12). Patients' demographics, clinical history, symptoms, physical examination findings, signs of diagnostic work-up, operative findings and early outcome were evaluated...
June 29, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Michael F Brinkley, Elisabeth T Tracy, Charles M Maxfield
Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require elective surgical correction, but the potential of malrotation with midgut volvulus demands prompt imaging evaluation. We review the various causes of congenital duodenal obstruction with an emphasis on the approach to imaging evaluation and diagnosis.
July 2016: Pediatric Radiology
Jeffrey J Leow, Terence Huey, Jee Keem Low
INTRODUCTION: Adult midgut volvulus is a rare surgical disease but remains an important cause of small bowel obstruction. It is most commonly secondary to postoperative adhesions. Primary cases may be due to congenital malformations. PRESENTATION OF CASE: We report the case of an adult primary midgut volvulus in a 35-year-old Chinese male. Based on the clinical presentation and investigations, the patient was presumed to have acute appendicitis. An open appendectomy was performed...
2016: International Journal of Surgery Case Reports
Christine Burgmeier, Felix Schier
IntroductionThe surgical treatment of the acute neonatal abdomen still poses a challenge in pediatric surgery. Various underlying etiologies require different surgical procedures. Until today the role of laparoscopy in the surgical treatment of the acute neonatal abdomen is controversial. The aim of this study was to analyze our experiences with laparoscopy and to perform a review of the literature. Methods Retrospective, single-institution study including all term and preterm neonates initially undergoing laparoscopy due to an acute abdomen...
April 28, 2016: Surgical Innovation
Britt Husberg, Karin Salehi, Trevor Peters, Ulf Gunnarsson, Margareta Michanek, Agneta Nordenskjöld, Karin Strigård
Congenital intestinal malrotation is mainly detected in childhood and caused by incomplete rotation and fixation of the intestines providing the prerequisites for life-threatening volvulus of the midgut. The objective of this study was to evaluate a large cohort of adult patients with intestinal malrotation. Thirty-nine patients, 15-67 years, were diagnosed and admitted to a university setting with congenital intestinal malrotation 2002-2013. The patients were divided into three age groups for stratified evaluation...
2016: SpringerPlus
Akile Zengin, Bercis İmge Uçar, Şükrü Aydın Düzgün, Zülfü Bayhan, Sezgin Zeren, Faik Yaylak, Bekir Şanal, Nilüfer Araz Bayhan
INTRODUCTION: Intestinal malrotation refers to the partial or complete failure of rotation of midgut around the superior mesenteric vessels in embryonic life. Arrested midgut rotation results due to narrow-based mesentery and increases the risk of twisting midgut and subsequent obstruction and necrosis. PRESENTATION OF CASE: 40 years old female patient admitted to emergency service with acute abdomen and computerized tomography scan showed dilated large and small intestine segments with air-fluid levels and twisted mesentery around superior mesenteric artery and vein indicating "whirpool sign"...
2016: International Journal of Surgery Case Reports
Pei Wen Chuang, Bo-Ming Huang, Chung Hsien Liu, Chien-Chin Chen, Ming-Jen Tsai
Appendicitis is a common surgical abdominal disease with various presentations. Its diagnosis may be obscured by asymptomatic congenital anatomical anomalies like midgut malrotation. Midgut malrotation is a rare fetal anomaly resulting from incomplete or failure of midgut rotation and fixation. It is mostly presented with bowel obstruction or volvulus in early life. Presentation in adult is rare. Here, we report an elderly patient presented with left lower abdominal pain and urinary tract infection. Abdominal computed tomography revealed left-sided appendicitis with non-rotational-type midgut malrotation...
December 2015: Indian Journal of Surgery
Melanie Drewett, Nav Johal, Charles Keys, Nigel J Hall, David Burge
PURPOSE: To determine the number of term infants with bilious vomiting (BV) referred to a neonatal surgical centre for exclusion of malrotation by upper gastrointestinal contrast (UGI) examination. METHODS: Retrospective review of term (>37/40) neonates <28 days of age undergoing UGI for exclusion of malrotation between Jan 2010 and Dec 2014 in a neonatal network with 30,000 term deliveries annually. Only infants with BV in the absence of alternative clinical/radiological diagnosis were included...
May 2016: Pediatric Surgery International
Yew-Wei Tan, Asma Khalil, Madhavi Kakade, Julene S Carvalho, Sarah Bradley, Stewart Cleeve, Stefano Giuliani
OBJECTIVE: To assess the role of screening and prophylactic surgery for intestinal rotational abnormalities (IRAs) in asymptomatic patients with heterotaxy. STUDY DESIGN: PubMed, Embase, and Cinahl were searched electronically to determine the overall incidence of IRAs in heterotaxy; the detection rate of IRAs associated with screening; the incidence of midgut volvulus in patients without screening; and the incidence of morbidity and mortality after prophylactic and emergency Ladd procedures...
April 2016: Journal of Pediatrics
A G Carroll, R G Kavanagh, C Ni Leidhin, N M Cullinan, L P Lavelle, D E Malone
RATIONALE AND OBJECTIVES: The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of upper and lower gastrointestinal (GI) tract obstruction in neonates and infants. METHODS: A focused clinical question was constructed and the literature was searched using the patient, intervention, comparison, outcome method comparing radiography, upper GI contrast study, and ultrasound in the detection of upper GI tract obstruction such as duodenal atresia and stenosis, jejunal and ileal atresia, and malrotation and volvulus...
May 2016: Academic Radiology
Nouredin Messaoudi, Koen Vanlede, Dirk Vervloessem, Marc Huyghe, Paul Leyman
Intestinal malrotation complicated by the development of midgut volvulus presents a difficult management dilemma because of the risk of short bowel syndrome. Here, we present our experience with a case of severe intestinal ischemia after derotation in a newborn successfully managed using systemic tissue plasminogen activator. The present report supports the usefulness of thrombolysis as a therapeutic option for reperfusion of ischemic small bowel due to midgut volvulus in neonates.
December 2015: European Journal of Pediatric Surgery Reports
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