scholarly journals Small bowel volvulus post gastric bypass

2019 ◽  
Vol 6 (2) ◽  
pp. 590
Author(s):  
Baillie W. C. Ferris
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Ct Scan ◽  
Early Recognition ◽  
Bowel Ischemia ◽  
Small Bowel Volvulus ◽  
Increased Risk ◽  
Whirl Sign ◽  
Computed Topography ◽  
Delays In Diagnosis

Small Bowel Volvulus (SBV) is an uncommon cause of Small Bowel Obstruction (SBO), which can be difficult to diagnose.  However, it is very important to recognise and intervene in a timely manner due to the high risk of bowel ischemia. Unfortunately, SBV does not always have clinical features that differentiate it from other causes of mechanical obstruction. The most reliable investigation appears to be Computed Topography (CT) scan with around 50% of patients displaying the classic ‘whirl’ sign on CT.  However, many remain undifferentiated SBO patients. Any of these patients who have any clinical or radiological suspicion of bowel ischemia, should be considered for surgery, as delays in diagnosis of bowel ischemia are associated with an increased risk of morbidity and mortality. In this case reported, author detailed a 55year female who presented with SBV had a CT scan which showed the classic ‘whirl’ sign and thus had timely surgical intervention and an uncomplicated recovery. Her history was significant for a subtotal colectomy, and a Rouxeny gastric bypass. This case highlights the importance of early recognition of SBV and also carries a reminder to consider rare causes of abdominal pain in patients who have had previous bariatric surgery. They have altered anatomy and thus are at increased risk of internal hernia and volvulus including SBV.

Chronic Adhesive Small Bowel Volvulus: “Whirl Sign” on CT-scan

2005 ◽  
Vol 105 (1) ◽  
pp. 118-120 ◽  
Author(s):  
H.-D. Lam ◽  
S. Mulier ◽  
L. A. Michel
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Volvulus ◽  
Whirl Sign

Whirl sign as CT finding in small-bowel volvulus

1995 ◽  
Vol 5 (5) ◽  
Author(s):  
K. Fujimoto ◽  
K. Nakamura ◽  
H. Nishio ◽  
S. Takashima ◽  
K. Minakuchi ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Volvulus ◽  
Whirl Sign ◽  
Ct Finding

scholarly journals Small bowel volvulus and the whirl sign

QJM ◽  
2009 ◽  
Vol 102 (11) ◽  
pp. 815-815 ◽  
Author(s):  
C.-H. Lin ◽  
P.-C. Kao ◽  
H.-P. Wang ◽  
W.-C. Lien
Keyword(s):  
Small Bowel ◽  
Small Bowel Volvulus ◽  
Whirl Sign

scholarly journals A CASE OF SECONDARY SMALL BOWEL VOLVULUS DIAGNOSED BY CT DEMONSTRATING WHIRL SIGN

1993 ◽  
Vol 54 (10) ◽  
pp. 2607-2610
Author(s):  
Kenji TAKEUCHI ◽  
Hidetaka WAGAYAMA ◽  
Kazumoto MURATA
Keyword(s):  
Small Bowel ◽  
Small Bowel Volvulus ◽  
Whirl Sign

Small Bowel Ischemia after Roux-en-Y Gastric Bypass Complicated by Pregnancy: A Case Report

2005 ◽  
Vol 71 (3) ◽  
pp. 231-234 ◽  
Author(s):  
Anthony Charles ◽  
Shirley Domingo ◽  
Aaron Goldfadden ◽  
Jason Fader ◽  
Richard Lampmann ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Gastric Bypass ◽  
Case Report ◽  
Small Bowel ◽  
Bowel Ischemia ◽  
Unusual Complication ◽  
Childbearing Age ◽  
Diffuse Abdominal Pain ◽  
Gastric Bypass Procedure ◽  
History Of

Small bowel obstruction is an unusual complication of pregnancy. Its occurrence after Roux- en-Y gastric bypass (RYGB) for morbid obesity complicated by pregnancy is rare. Morbid obesity describes body weight at least 100 lb over the ideal weight, or a body mass index (BMI) ≥40. Surgery offers the only viable treatment option with long-term weight loss and maintenance. This case report involves a 23-year-old female at 25 weeks gestation with a 1-day history of diffuse abdominal pain and vomiting. She had a RYGB with a 15 cc micropouch 6 months prior to the commencement of this pregnancy. All radiologic investigations were normal. Esophagogastroscopy was performed revealing an ischemic Roux limb of the gastric bypass. At laparotomy, an internal hernia involving the afferent limb was identified at the site of the Roux anastomosis compromising portions of both the afferent and Roux limbs. Nonviable portions of both the afferent and Roux limbs were resected. Gastrointestinal continuity was achieved by fashioning a gastro-gastrostomy and a jejuno-jejunostomy, thus reversing the original gastric bypass procedure. The immediate postoperative period was complicated by fetal demise. With the increase in bariatric surgery, small bowel ischemia after Roux- en-Y gastric bypass will most likely become more prevalent, particularly in women of childbearing age.

Bowel Ischemia Score Predicts Early Operation in Patients With Adhesive Small Bowel Obstruction

2021 ◽  
pp. 000313482098882
Author(s):  
Rachel S. Morris ◽  
Patrick Murphy ◽  
Kelly Boyle ◽  
Louis Somberg ◽  
Travis Webb ◽  
...  
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Characteristic Curve ◽  
Small Bowel Resection ◽  
Bowel Ischemia ◽  
Operative Intervention ◽  
Early Operation ◽  
Adhesive Small Bowel Obstruction

Background Nonoperative management of adhesive small bowel obstruction (SBO) is successful in up to 80% of patients. Current recommendations advocate for computed tomography (CT) scan in all patients with SBO to supplement surgical decision-making. The hypothesis of this study was that cumulative findings on CT would predict the need for operative intervention in the setting of SBO. Methods This is an analysis of a retrospectively and prospectively collected adhesive SBO database over a 6-year period. A Bowel Ischemia Score (BIS) was developed based on the Eastern Association for the Surgery of Trauma guidelines of CT findings suggestive of bowel ischemia. One point was assigned for each of the six variables. Early operation was defined as surgery within 6 hours of CT scan. Results Of the 275 patients in the database, 249 (90.5%) underwent CT scan. The operative rate was 28.3% with a median time from CT to operation of 21 hours (Interquartile range 5.2-59.2 hours). Most patients (166/217, 76.4%) with a BIS of 0 or 1 were successfully managed nonoperatively, whereas the majority of those with a BIS of 3 required operative intervention (5/6, 83.3%). The discrimination (area under the receiver operating characteristic curve) of BIS for early surgery, any operative intervention, and small bowel resection were 0.83, 0.72, and 0.61, respectively. Conclusion The cumulative signs of bowel ischemia on CT scan represented by BIS, rather than the presence or absence of any one finding, correlate with the need for early operative intervention.

scholarly journals Abdominal Computed Tomography with a Twist: The ‘Whirl Sign’ for Mesenteric Volvulus

2020 ◽  
Vol 4 (3) ◽  
pp. 470-471
Author(s):  
Jodi Spangler ◽  
Jonathan Ilgan
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Early Recognition ◽  
Whirl Sign ◽  
Critical Patients ◽  
Low Incidence ◽  
Stage Renal Disease ◽  
End Stage

Case Presentation: A 55-year-old woman with a history of end-stage renal disease, peripheral vascular disease, and multiple prior abdominal surgeries presented to the emergency department with three days of diffuse, severe, abdominal pain with accompanying nausea, emesis, and food intolerance. A computed tomography (CT) of her abdomen demonstrated a “whirl” of small bowel and mesenteric vessels, raising suspicion for mesenteric volvulus and resultant small bowel obstruction. Discussion: Mesenteric volvulus is a low incidence, high mortality condition; therefore, early recognition and operative intervention are critical. Patients with a “whirl sign” on CT are more likely to require surgical intervention for their small bowel obstruction.

scholarly journals Whirl sign in small bowel volvulus

2012 ◽  
Vol 2012 (aug09 1) ◽  
pp. bcr2012006688-bcr2012006688 ◽  
Author(s):  
Y. M. Huang ◽  
C. C. J. Wu
Keyword(s):  
Small Bowel ◽  
Small Bowel Volvulus ◽  
Whirl Sign
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