scholarly journals Volvulus with sigmoid necrosis in children: Two cases observed at Ignace Deen Hospital

2021 ◽  
Vol 9 (1) ◽  
pp. 028-031
Author(s):  
Fofana Houssein ◽  
Camara Soriba Naby ◽  
Keïta Karim ◽  
Fofana Naby ◽  
Soumaoro Labile Togba ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Bowel Obstruction ◽  
Surgical Procedures ◽  
Clinical Observation ◽  
Sigmoid Volvulus ◽  
X Rays ◽  
Abdominal Emergency ◽  
Mechanical Bowel Obstruction ◽  
Male Patients ◽  
The Ideal

Introduction: We report the clinical observation of 2 cases of volvulus with sigmoid necrosis in children. Observation: Two male patients, aged 12 and 15, were hospitalized with acute mechanical bowel obstruction. There was an asymmetric, motionless meteorism and rectal emptiness. X-rays of the abdomen revealed an arch. Laparotomy found volvulus with necrosis of the sigmoid colon. The Hartmann-type colostomy and the ideal colectomy were the surgical procedures. Conclusion: Sigmoid volvulus is a rare abdominal emergency in children and severe in the necrosis stage.

scholarly journals A Symptomatic Coffee Bean: Acute Sigmoid Volvulus

2017 ◽  
Vol 11 (2) ◽  
pp. 348-351 ◽  
Author(s):  
Michael Scharl ◽  
Luc Biedermann
Keyword(s):  
Sigmoid Colon ◽  
Guide Wire ◽  
Outlet Obstruction ◽  
Primary Treatment ◽  
Sigmoid Volvulus ◽  
Coffee Bean ◽  
Diagnostic Colonoscopy ◽  
X Ray ◽  
Abdominal Emergency ◽  
Distended Abdomen

An acute sigmoid volvulus is due to the torsion of the sigmoid colon around its mesenteric axis. It mainly occurs in elderly patients and represents an abdominal emergency requiring urgent treatment. A 53-year-old male patient with severe craniocerebral injury and traumatic subarachnoidal bleeding 3 weeks prior presented on the ward with distended abdomen without abdominal pain, muscular defense, or resistances. He featured large volume diarrhea within the last few hours without signs of bleeding. A plain abdominal X-ray demonstrated a coffee bean sign indicating a sigmoid volvulus. A consequent CT scan of the abdomen revealed a deep outlet obstruction with massively dilated, elongated and twisted loop of the sigmoid colon and no signs of perforation. We performed emergency colonoscopy under the assumption of an acute sigmoid volvulus. After careful insertion of the endoscope completely refraining from insufflation of air or CO2, endoscopic reposition of the sigma could be achieved and a colonic drainage was placed over an inserted guide wire up to the proximal transverse colon. No relapse occurred and a diagnostic colonoscopy after 4 weeks revealed no tumor or polyps. Our report describes a classic case of acute sigmoid volvulus and undermines the potential of colonoscopy as conservative primary treatment of choice.

scholarly journals Large Bowel Obstruction Due to a Big Gallstone Successfully Treated with Endoscopic Mechanical Lithotripsy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Marco Balzarini ◽  
Laura Broglia ◽  
Giovanni Comi ◽  
Calcedonio Calcara
Keyword(s):  
High Risk ◽  
Sigmoid Colon ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Colonic Obstruction ◽  
Gallstone Ileus ◽  
Large Bowel Obstruction ◽  
Mechanical Lithotripsy ◽  
Mechanical Bowel Obstruction

Colonic gallstone ileus in an uncommon mechanical bowel obstruction caused by intraluminal impaction of one or more gallstones. The surgical management of gallstone ileus is complex and is potentially of high risk. There have been reports of gallstone extractions using various endoscopic modalities to relieve the obstruction. In this report we present the technique employed to successfully perform a mechanical lithotripsy and extraction of a large gallstone embedded in a sigmoid colon affected by diverticular stenosis. We passed through the stenosis with a 11.3 mm videoscope with 3.7 mm channel. A large lithotripsy extraction basket was used to catch and break up the stone and fragments were removed using the same basket. The patient was discharged asymptomatic three days after the procedure. Using appropriate devices mechanical lithotripsy is a safe and effective method to treat colonic obstruction and avoid surgery in the setting of gallstone ileus even in case of big stones.

scholarly journals Pediatric sigmoid volvulus of an extremely long sigmoid colon with hypoganglionosis: a case report

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110324
Author(s):  
Matjaž Horvat ◽  
Marko Hazabent ◽  
Marjan Sekej ◽  
Milka Kljaić Dujić
Keyword(s):  
Sigmoid Colon ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Treatment Options ◽  
Vascular Occlusion ◽  
Abdominal Distension ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
History Of

Sigmoid volvulus is an extremely rare cause of intestinal obstruction in pediatric patients. This condition occurs when a redundant sigmoid loop with a narrow mesenteric base of attachment to the posterior abdominal wall rotates around its mesenteric axis. This situation might result in vascular occlusion and large bowel obstruction. There are only a few predisposing factors of sigmoid volvulus, such as a long-term history of constipation or pseudo-obstruction with an excessive sigmoid colon. Underlying hypoganglionosis can also lead to large bowel obstruction. There have only been two reported cases of hypoganglionosis with sigmoid volvulus, and both were in adults. Sigmoid volvulus usually presents with abdominal pain, nausea, vomiting, constipation and abdominal distension, an absence of stool, or the presence of melenic stool in the rectum. Initial treatment options are non-surgical for stable patients, although surgical management might be necessary. If sigmoid volvulus is not recognized and resolved, it may lead to serious complications and death. Pediatric sigmoid volvulus is frequently the fulminant type, and therefore, a decision about treatment must be prompt. We present an unusual pediatric case of an extremely long sigmoid colon with hypoganglionosis, which twisted and caused obstruction. This condition was resolved with surgical resection.

scholarly journals THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Soto Dopazo ◽  
E Pérez Prudencio ◽  
A Arango Bravo ◽  
C Nuño Iglesias ◽  
C Mateos Palacios ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Broad Ligament ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Exploratory Laparotomy ◽  
X Rays ◽  
Intestinal Necrosis ◽  
Urgent Surgery ◽  
Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

The role of the anatomy of the sigmoid colon in developing sigmoid volvulus: a cross-sectional study

2012 ◽  
Vol 35 (3) ◽  
pp. 249-257 ◽  
Author(s):  
Olusegun Isaac Alatise ◽  
Olusegun Ojo ◽  
Polycarp Nwoha ◽  
Ganiyat Omoniyi-Esan ◽  
Abidemi Omonisi
Keyword(s):  
Sigmoid Colon ◽  
Cross Sectional Study ◽  
Sigmoid Volvulus ◽  
Sectional Study ◽  
Cross Sectional

A high-energy triple-axis X-ray diffractometer for the study of the structure of bulk crystals

2004 ◽  
Vol 37 (6) ◽  
pp. 901-910 ◽  
Author(s):  
C. Seitz ◽  
M. Weisser ◽  
M. Gomm ◽  
R. Hock ◽  
A. Magerl
Keyword(s):  
High Energy ◽  
X Rays ◽  
Bulk Crystals ◽  
X Ray Diffraction ◽  
X Ray ◽  
Peak Intensity ◽  
High Penetration ◽  
Massive Sample ◽  
Laue Geometry ◽  
The Ideal

A triple-axis diffractometer for high-energy X-ray diffraction is described. A 450 kV/4.5 kW stationary tungsten X-ray tube serves as the X-ray source. Normally, 220 reflections of thermally annealed Czochralski Si are employed for the monochromator and analyser. Their integrated reflectivity is about ten times higher than the ideal crystal value. With the same material as the sample, and working with the WKα line at 60 keV in symmetric Laue geometry for all axes, the full width at half-maximum (FWHM) values for the longitudinal and transversal resolution are 2.5 × 10−3and 1.1 × 10−4for ΔQ/Q, respectively, and the peak intensity for a non-dispersive setting is 3000 counts s−1. In particular, for a double-axis mode, an energy well above 100 keV from theBremsstrahlungspectrum can be used readily. High-energy X-rays are distinguished by a high penetration power and materials of several centimetre thickness can be analysed. The feasibility of performing experiments with massive sample environments is demonstrated.

scholarly journals Abdominal emergency surgery in patients over 90 years old: is it worthwhile? An Italian multicenter retrospective study

2016 ◽  
Author(s):  
Antonio Tarasconi ◽  
Fausto Catena ◽  
Hariscine K. Abongwa ◽  
Belinda De Simone ◽  
Federico Coccolini ◽  
...  
Keyword(s):  
Survival Rate ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Procedures ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Asa Score ◽  
Abdominal Emergency ◽  
Emergency Abdominal Surgery

Unlike other surgical fields, such as cardiac surgery, where many trials have been made about safety, feasibility and outcome of surgical procedures in the elderly, there is lack of literature about emergency abdominal surgery in very old patients, especially in people over 90 years of age. The available data reported survival of about 50% one year after the operation. The aim of the study is to determine the survival rate two years after emergency abdominal surgery in a nonagenarian population and to identify any demographic and surgical parameters that could predict a poor outcome in this type of patient. The study was a retrospective multicenter trial. Patient inclusion criteria were: age 90 years old or older, urgent abdominal surgery. The medical charts reviewed and data collected were: gender, age, the American Society of Anesthesiologists (ASA) score and comorbidities, diagnosis, time elapsed between arrival to the Emergency Room and admission to the Operatory Room, surgical procedures, open versus laparoscopic procedure, type of anesthesia and outcomes with hospital length of stay. Phone call follow-up was performed for patient discharged alive and Kaplan-Meier analysis was used to evaluate survival. We identified 72 (20 males and 52 females) nonagenarian patients who underwent abdominal emergency surgery at 6 Italian hospitals (Parma, Bergamo, Bologna, Brescia, Chiari, Adria). Mean age was 92.5 years [range 90-100, standard deviation (SD) 2.6], median ASA score was 3 (range 2-5, mean 3.32) and only 7 patients were without comorbidities. Mean hospital length of stay was 13 days (range 1-60, SD 11.52); 56 patients (77.7%) were discharged alive; 2 years survival rate was 23% [mean follow-up=10 months (range 1-27)]. Among all the parameters analyzed, only ASA score was significantly correlated with survival. Neither the presence of malignancy nor the absence of comorbidities seems to correlate with survival. Nonagenarian patients undergoing emergent abdominal surgical procedures have a high overall in-hospital mortality rate (23%) and a low 2 years survival rate (51.4%). Except for ASA score, there are no other factors predicting poor outcome. Based on the present study emergency abdominal surgery in frail patients over 90 years of age has to be carefully evaluated: only 1 out 5 patients will be alive after 2 years.

scholarly journals COLORECTAL CARCINOMA;

2013 ◽  
Vol 20 (03) ◽  
pp. 472-477
Author(s):  
MOHAMMAD ADNAN NAZEER ◽  
QAMAR SHAHZAD ◽  
HARUN MAJID DAR ◽  
Asma Samreen ◽  
Humaira Aalam
Keyword(s):  
Colorectal Carcinoma ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Standing Position ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
Colorectal Cancers ◽  
Fluid Interfaces ◽  
Biochemical Tests ◽  
Age Range

Introduction: Large bowel obstruction due to colorectal carcinoma occurs in up to 20% of the patients and usually2-4 accompanied by morbidity and mortality . Almost 25 % deaths occur post-operatively following surgery for colorectal cancers occur in1 those who initially present with obstruction . Usually elderly patients with associated co-morbidities presents with bowel obstruction.Objective: Find out the frequency of colorectal cancers in patients presenting with large bowel obstruction. Design: Prospective crosssectional study. Setting: Shaikh Zayed Hospital Lahore. Period: from 31st December 2010 to 31st December 2012. Materials &Methods: A total 20 patients were presented with large bowel obstruction with the age ranges between 40 to 70 years. All the 20 patientsunderwent routine haematological and biochemical tests. In these patients an abdominal x-ray in a supine or standing position was takenand dilated loops of bowel, air-fluid interfaces, or both was observed then Contrast radiography(Barium/gastrograffin) was done todefine the site and extent of the obstruction. An abdominal computed tomography scan was done to evaluate the extent of the disease.Colonoscopy was also carried out in the patients with colorectal cancers to find out the size and location of the tumor and biopsy taken bycolonoscope. Results: 12 patients out of 20 presented with large bowel obstruction were diagnosed to have a colorectal cancers and theage ranges from 60 to 70 years. The 8 patients were diagnosed to have a sigmoid colonic tumour and 4 patients were suffering from atumour of recto sigmoid junction. Whereas in rest of the 8 patients the large bowel obstruction was due to other benign causes likevolvulus and intussusception and age range was 50 – 60 years. 6 patients were suffering from sigmoid volvulus and remaining 2 hadcolo-colic intussusception. Conclusions: It is concluded that the major cause of the large bowel obstruction is the left sided colorectalcancers the tumours of recto sigmoid junction.

Sign in / Sign up

Export Citation Format

Share Document