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Intestinal Malrotation and Obstruction Disorders

Works Count: 34264

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Description

This cluster of papers covers a wide range of intestinal disorders, including intestinal malrotation, pyloric stenosis, colonic volvulus, duodenal atresia, and acute colonic pseudo-obstruction. It also discusses genetic mutations (TTC7A), neostigmine treatment, and the use of laparoscopic surgery for these conditions.

Keywords

Intestinal Malrotation; Pyloric Stenosis; Colonic Volvulus; Duodenal Atresia; Acute Colonic Pseudo-Obstruction; TTC7A Mutations; Neostigmine Treatment; Sigmoid Volvulus; Laparoscopic Surgery; Congenital Anomalies

Congenital atresia of the intestine: pathogenesis and treatment.

1961-12-01

Thomas V. Santulli , William A. Blanc

Illustrated trilingual glossary of morphological and anatomical terms applied to Octocorallia

1983-01-01

Frederick M. Bayer , Manfred Grasshoff , J. Verseveldt

Chronic intestinal pseudoobstruction

1978-05-01

David L. Faulk , Sinn Anuras , James Christensen

Scintigraphic measurement of regional gut transit in idiopathic constipation

1991-07-01

Todd Stivland , Michael Camilleri , Mario Vassallo +6 more

Establishing norms for intestinal length in children

2009-05-01

Marie-Chantal Struijs , Ivan Diamond , Nicole de Silva +1 more

Peritoneal Drainage or Laparotomy for Neonatal Bowel Perforation?

2008-07-01

Clare M. Rees , Simon Eaton , Edward M. Kiely +3 more

In Brief Objective: To determine whether primary peritoneal drainage improves survival and outcome of extremely low birth weight (ELBW) infants with intestinal perforation. Summary Background Data: Optimal surgical management of … In Brief Objective: To determine whether primary peritoneal drainage improves survival and outcome of extremely low birth weight (ELBW) infants with intestinal perforation. Summary Background Data: Optimal surgical management of ELBW infants with intestinal perforation is unknown. Methods: An international multicenter randomized controlled trial was performed between 2002 and 2006. Inclusion criteria were birthweight ≤1000 g and pneumoperitoneum on x-ray (necrotizing enterocolitis or isolated perforation). Patients were randomized to peritoneal drain or laparotomy, minimizing differences in weight, gestation, ventilation, inotropes, platelets, country, and on-site surgical facilities. Patients randomized to drain were allowed to have a delayed laparotomy after at least 12 hours of no clinical improvement. Results: Sixty-nine patients were randomized (35 drain, 34 laparotomy); 1 subsequently withdrew consent. Six-month survival was 18/35 (51.4%) with a drain and 21/33 (63.6%) with laparotomy (P = 0.3; difference 12% 95% CI, −11, 34%). Cox regression analysis showed no significant difference between groups (hazard ratio for primary drain 1.6; P = 0.3; 95% CI, 0.7–3.4). Delayed laparotomy was performed in 26/35 (74%) patients after a median of 2.5 days (range, 0.4–21) and did not improve 6-month survival compared with primary laparotomy (relative risk of mortality 1.4; P = 0.4; 95% CI, 0.6–3.4). Drain was effective as a definitive treatment in only 4/35 (11%) surviving neonates, the rest either had a delayed laparotomy or died. Conclusions: Seventy-four percent of neonates treated with primary peritoneal drainage required delayed laparotomy. There were no significant differences in outcomes between the 2 randomization groups. Primary peritoneal drainage is ineffective as either a temporising measure or definitive treatment. If a drain is inserted, a timely "rescue" laparotomy should be considered. Trial registration number ISRCTN18282954; http://isrctn.org/ In an international randomized controlled trial comparing peritoneal drain with laparotomy in extremely low birth weight infants with pneumoperitoneum, there was no survival advantage with drain and most patients required laparotomy.

Chronic idiopathic intestinal pseudo-obstruction: clinical and intestinal manometric findings.

1987-01-01

Vincenzo Stanghellini , Michael Camilleri , J.‐R. Malagelada

We report the clinical and intestinal manometric findings in a group of 42 patients with chronic idiopathic intestinal pseudo-obstruction evaluated at the Mayo Clinic. The main clinical manifestations in these … We report the clinical and intestinal manometric findings in a group of 42 patients with chronic idiopathic intestinal pseudo-obstruction evaluated at the Mayo Clinic. The main clinical manifestations in these patients were nausea and vomiting (83%), abdominal pain (74%), distension (57%), constipation (36%), diarrhoea (29%), and urinary symptoms (17%). These symptoms preceded surgery in all patients. Air fluid levels or distended bowel loops occurred in 57% and a dilated bladder or urinary excretory pathway in 17%. All patients showed intestinal manometric abnormalities none of which are seen in healthy individuals: aberrant configuration or propagation of interdigestive motor complexes in 25 patients; bursts (greater than 2 min duration) of non-propagated phasic pressure activity in fasting and/or fed state in 30 patients; sustained incoordinated fasting pressure activity in 15 patients; and inability of an ingested meal to convert fasting into fed pattern in 28 patients. We conclude that qualitative analysis of intestinal manometry provides evidence of gut dysmotility in patients with the clinical syndrome of chronic intestinal pseudo-obstruction. These abnormalities of motility can help to establish the correct diagnosis.

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Reversible Vascular Occlusion of the Colon

1970-05-01

James E. Davis

Normal intestinal length in preterm infants

1983-12-01

Robert J. Touloukian , G.J. Walker Smith

Acute pseudo-obstruction of the colon (Ogilvie's syndrome)

1986-03-01

Vincent W. Vanek , Musbah Al-Salti

This study analyzes 400 cases of acute pseudo-obstruction of the colon (Ogilvie's syndrome). Seven cases were reported at St. Elizabeth Hospital Medical Center between October 1982 and February 1985; 393 … This study analyzes 400 cases of acute pseudo-obstruction of the colon (Ogilvie's syndrome). Seven cases were reported at St. Elizabeth Hospital Medical Center between October 1982 and February 1985; 393 cases were reported in the literature from 1970-1985. Ogilvie's syndrome is most commonly reported in patients in the sixth decade, and is more predominant in men. It is caused by an unknown disturbance to the autonomic innervation of the distal colon, and is associated with different conditions. Plain abdominal roentgenogram is the most useful diagnostic test. If the cecal diameter is 12 cm or greater, or conservative management is unsuccessful, colonoscopic or operative decompression is needed. The mode of treatment, age, cecal diameter, delay in decompression, and status of the bowel significantly influence the mortality rate, which is approximately 15 percent with early appropriate management, compared with 36 to 44 percent in perforated or ischemic bowel.

Volvulus of the Colon

1985-07-01

Garth H. Ballantyne , Michael D. Brandner , Robert W. Beart +1 more

BALLANTYNE, GARTH H. M.D.; BRANDNER, MICHAEL D. M.D.; BEART, ROBERT w. JR. M.D.; ILSTRUP, DUANE M. M.S. Author Information BALLANTYNE, GARTH H. M.D.; BRANDNER, MICHAEL D. M.D.; BEART, ROBERT w. JR. M.D.; ILSTRUP, DUANE M. M.S. Author Information

Intestinal Adaptation

1978-06-29

R C N Williamson

Intrinsic Regulation of Cell RenewalIn normal circumstances, the constant turnover of the small-bowel mucosa is maintained by a dynamic equilibrium between cell production at the base of the crypt and … Intrinsic Regulation of Cell RenewalIn normal circumstances, the constant turnover of the small-bowel mucosa is maintained by a dynamic equilibrium between cell production at the base of the crypt and cell loss at the tip of the villus. This turnover recapitulates the embryologic development of the intestinal epithelium from undifferentiated stem cells to mature enterocytes in intimate relation to the lamina propria.171 Even in atrophic defunctioned bowel or mucosal biopsies maintained by organ culture, epithelial cells continue to replicate in the crypts and differentiate during migration onto the villi.7,48,86 The failure of mitotic inhibition by . . .

The inheritance of liability to certain diseases, estimated from the incidence among relatives

1965-08-01

D. S. Falconer

Malrotation of the intestine

1993-05-01

A. Margarita Torres , Moritz M. Ziegler

Intestinal Atresia and Stenosis

1998-05-01

Laura K. Dalla Vecchia , Jay L. Grosfeld , Karen W. West +3 more

<h3>Objective</h3> To evaluate the causes, clinical presentation, diagnosis, operative management, postoperative care, and outcome in infants with intestinal atresia. <h3>Design</h3> Retrospective case series. <h3>Setting</h3> Pediatric tertiary care teaching hospital. <h3>Patients</h3> … <h3>Objective</h3> To evaluate the causes, clinical presentation, diagnosis, operative management, postoperative care, and outcome in infants with intestinal atresia. <h3>Design</h3> Retrospective case series. <h3>Setting</h3> Pediatric tertiary care teaching hospital. <h3>Patients</h3> A population-based sample of 277 neonates with intestinal atresia and stenosis treated from July 1, 1972, through April 30, 1997. The level of obstruction was duodenal in 138 infants, jejunoileal in 128, and colonic in 21. Of the 277 neonates, 10 had obstruction in more than 1 site. Duodenal atresia was associated with prematurity (46%), maternal polyhydramnios (33%), Down syndrome (24%), annular pancreas (33%), and malrotation (28%). Jejunoileal atresia was associated with intrauterine volvulus, (27%), gastroschisis (16%), and meconium ileus (11.7%). <h3>Interventions</h3> Patients with duodenal obstruction were treated by duodenoduodenostomy in 119 (86%), of 138 patients duodenotomy with web excision in 9 (7%), and duodenojejunostomy in 7 (5%) A duodenostomy tube was placed in 3 critically ill neonates. Patients with jejunoileal atresia were treated with resection in 97 (76%) of 128 patients (anastomosis, 45 [46]; tapering enteroplasty, 23 [24]; or temporary ostomy, 29 [30]), ostomy alone in 25 (20%), web excision in 5 (4%), and the Bianchi procedure in 1(0.8%). Patients with colon atresia were managed with initial ostomy and delayed anastomosis in 18 (86%) of 21 patients and resection with primary anastomosis in 3 (14%). Short-bowel syndrome was noted in 32 neonates. <h3>Main Outcome Measures</h3> Morbidity and early and late mortality. <h3>Results</h3> Operative mortality for neonates with duodenal atresia was 4%, with jejunoileal atresia, 0.8%, and with colonic atresia, 0%. The long-term survival rate for children with duodenal atresia was 86%; with jejunoileal atresia, 84%; and with colon atresia, 100%. The Bianchi procedure (1 patient, 0.8%) and growth hormone, glutamine, and modified diet (4 patients, 1%) reduced total parenteral nutrition dependence. <h3>Conclusions</h3> Cardiac anomalies (with duodenal atresia) and ultrashort-bowel syndrome (<40 cm) requiring long-term total parenteral nutrition, which can be complicated by liver disease (with jejunoileal atresia), are the major causes of morbidity and mortality in these patients. Use of growth factors to enhance adaptation and advances in small bowel transplantation may improve long-term outcomes.

Surgical Treatment of Idiopathic Hypertrophic Subaortic Stenosis

1961-08-01

Andrew G. Morrow , Edwin C. Brockenbrough

Growth and Development of an Infant Receiving All Nutrients Exclusively by Vein

1968-03-04

Douglas W. Wilmore

An infant weighing 2,300 gm (5 lb 1 oz) with atresia of the small bowel from the ligament of Treitz to within 3 cm of the ileocecal junction, and partial … An infant weighing 2,300 gm (5 lb 1 oz) with atresia of the small bowel from the ligament of Treitz to within 3 cm of the ileocecal junction, and partial atresia of the colon, declined postoperatively to 1,816 gm (4 lb) despite vigorous but conventional supportive care. A 30% solution containing all required nitrogen, calories, and essential nutrients was then infused continuously into the superior vena cava for 44 days when gastrointestinal dysfunction precluded enteral feeding. During the period when nutrition was given entirely intravenously, normal growth and development accompanied increases of 5.0 cm (1.9 in) in head circumference, 6.3 cm (2.5 in) in length, and 1,447 gm (3 lb 3 oz) in weight.

Intestinal malrotation: Varied clinical presentation from infancy through adulthood

2010-08-19

Deepika Nehra , Allan M. Goldstein

Operative management of intestinal atresia and stenosis based on pathologic findings

1979-06-01

Jay L. Grosfeld , Thomas V.N. Ballantine , Robert Shoemaker

Effect of Dietary Inulin Supplementation on Inflammation of Pouch Mucosa in Patients With an Ileal Pouch-Anal Anastomosis

2002-05-01

C.F.M. Welters , Erik Heineman , Erik Thunnissen +3 more

PURPOSE: Inflammation is a constant finding in the ileal reservoir of patients with an ileal pouch-anal anastomosis and is associated with decreased fecal concentrations of the short chain fatty acid … PURPOSE: Inflammation is a constant finding in the ileal reservoir of patients with an ileal pouch-anal anastomosis and is associated with decreased fecal concentrations of the short chain fatty acid butyrate, increased fecal pH, changes in fecal flora, and increased concentrations of secondary bile acids. In healthy subjects, inulin, a dietary fiber, is fermented to short chain fatty acids and leads to a lower pH and potentially beneficial changes in fecal flora. The aim of the present study was to investigate the effect of enteral supplementation of inulin on inflammation of the ileal reservoir. METHODS: Twenty patients received 24 g of inulin or placebo daily during three weeks in a randomized, double-blind, crossover design. Stools were analyzed after each test period for pH, short chain fatty acids, microflora, and bile acids. Inflammation was assessed endoscopically, histologically, and clinically. RESULTS: Compared with placebo, three weeks of dietary supplementation with 24 g of inulin increased butyrate concentrations, lowered pH, decreased numbers ofBacteroides fragilis, and diminished concentrations of secondary bile acids in feces. This was endoscopically and histologically accompanied by a reduction of inflammation of the mucosa of the ileal reservoir. CONCLUSION: Enteral inulin supplementation leads to a decrease of inflammation-associated factors and to a reduction of inflammation of pouch mucosa.

Infantile Hypertrophic Pyloric Stenosis

2003-05-01

Marta Hernanz‐Schulman

Infantile hypertrophic pyloric stenosis is a common condition affecting young infants; despite its frequency, it has been recognized only for a little over a century, and its etiology remains unknown. … Infantile hypertrophic pyloric stenosis is a common condition affecting young infants; despite its frequency, it has been recognized only for a little over a century, and its etiology remains unknown. Nevertheless, understanding of the condition and of effective treatment have undergone a remarkable evolution in the 20th century, reducing the mortality rate from over 50% to nearly 0%. The lesion is characterized by gastric outlet obstruction and multiple anatomic abnormalities of the pyloric antrum. The antropyloric muscle is abnormally thickened and innervated, and the intervening lumen is obstructed by crowded and redundant mucosa. Recognition of the obstructive role of the mucosa led to discovery of effective surgical treatment. Accurate clinical diagnosis in patients in whom a thickened antropyloric muscle is not readily palpable can be difficult, resulting in delayed diagnosis and can lead to emaciation and electrolyte imbalance, making the patient a suboptimal surgical candidate. Current imaging techniques, particularly sonography, are noninvasive and accurate for identification of infantile hypertrophic pyloric stenosis. Successful imaging requires understanding of anatomic changes that occur in patients with this condition and plays an integral role in patient care. Accurate, rapid, noninvasive imaging techniques facilitate rapid referral of vomiting infants and prompt surgical treatment of more suitable surgical candidates. © RSNA, 2003

An Algorithm for the Management of Sigmoid Colon Volvulus and the Safety of Primary Resection: Experience with 827 Cases

2007-01-04

Durkaya Ören , Selçuk S. Atamanalp , Bülent Aydınlı +4 more

This study was designed to review the outcomes of emergent treatment of sigmoid colon volvulus.The records of 827 patients were reviewed retrospectively.The mean age was 57.9 years (range, 10 weeks … This study was designed to review the outcomes of emergent treatment of sigmoid colon volvulus.The records of 827 patients were reviewed retrospectively.The mean age was 57.9 years (range, 10 weeks to 98 years), and 688 patients (83.2 percent) were male. Nonoperative reduction was applied in 575 patients (barium enema in 13, rigid sigmoidoscopy in 351, and flexible sigmoidoscopy in 211, with rectal tube placement in all patients). The results were as follows: success of 78.1 percent, mortality of 0.9 percent, complication of 3 percent, and early recurrence of 3.3 percent. Surgical treatment was performed on 393 patients (detorsion in 46, mesosigmoidopexy in 56, exteriorization in 4, resection with Hartmann's procedure in 146, resection with Mikulicz procedure in 14, resection with primary anastomosis in 51, tube cecostomy and colonic cleansing with resection in 75, and laparotomy in 1). The results were as follows: mortality of 15.8 percent, complication of 37.2 percent, early recurrence of 0.8 percent, and late recurrence of 6.7 percent.Nonoperative reduction is the initial treatment of sigmoid colon volvulus, and flexible sigmoidoscopy with rectal tube placement can be used successfully. Patients in whom bowel gangrene or peritonitis is present or nonoperative treatment is unsuccessful need emergency surgery. In surgical treatment, resection and primary anastomosis is the first choice, and it can be performed with acceptable mortality and morbidity rates if the patient is stable and a tension-free anastomosis is possible. Nondefinitive procedures have high recurrence rates; thus, definitive surgical techniques must be preferred.

Nitric Oxide Synthase Activity in Infantile Hypertrophic Pyloric Stenosis

1992-08-20

Jean-Marie Vanderwinden , Pierre Mailleux , Serge N. Schiffmann +2 more

Hypertrophic pyloric stenosis is a common infantile disorder characterized by enlarged pyloric musculature and gastric-outlet obstruction. Its physio-pathologic mechanism is not known, but a defect in pyloric relaxation (pylorospasm) has … Hypertrophic pyloric stenosis is a common infantile disorder characterized by enlarged pyloric musculature and gastric-outlet obstruction. Its physio-pathologic mechanism is not known, but a defect in pyloric relaxation (pylorospasm) has been postulated. Nitric oxide is a mediator of relaxation in the mammalian digestive tract, raising the possibility that pylorospasm could be caused by a defect in nitric oxide production. Since neuronal nitric oxide synthase and NADPH diaphorase are identical, we used the NADPH diaphorase histochemical reaction to study the distribution of nitric oxide synthase in pyloric tissue from patients with infantile hypertrophic pyloric stenosis.

Factors correlating with a successful outcome following extensive intestinal resection in newborn infants

1972-01-01

Douglas W. Wilmore

Systematic review: acute colonic pseudo‐obstruction

2005-10-21

Michael D. Saunders , Michael B. Kimmey

Acute colonic pseudo-obstruction is the clinical syndrome of acute large bowel dilatation without mechanical obstruction that is an important cause of morbidity and mortality. Acute colonic pseudo-obstruction occurs in hospitalized … Acute colonic pseudo-obstruction is the clinical syndrome of acute large bowel dilatation without mechanical obstruction that is an important cause of morbidity and mortality. Acute colonic pseudo-obstruction occurs in hospitalized or institutionalized patients with serious underlying medical and surgical conditions. The pathogenesis of acute colonic pseudo-obstruction is not completely understood but likely results from an imbalance in the autonomic regulation of colonic motor function. Metabolic or pharmacological factors, as well as spinal or retroperitoneal trauma, may alter the autonomic regulation of colonic function, leading to excessive parasympathetic suppression or sympathetic stimulation. This imbalance results in colonic atony and dilatation. Early recognition and appropriate management are critical to minimizing morbidity and mortality. The mortality rate is estimated at 40% when ischaemia or perforation occurs. The best-studied treatment of acute colonic pseudo-obstruction is intravenous neostigmine, which leads to prompt colon decompression in the majority of patients after a single infusion. In patients failing or having contraindications to neostigmine, colonoscopic decompression is the active intervention of choice. Surgery is reserved for those with peritonitis or perforation.

CONGENITAL INTESTINAL ATRESIA OBSERVATIONS ON ITS ORIGIN

1955-11-01

J H Louw , C.N. Barnard

The Management of Cecal Volvulus

2002-02-01

T E Madiba , S R Thomson , James M. Church

Cecal volvulus is second only to sigmoid volvulus in its frequency of occurrence. Diagnostic doubt is not uncommon in cecal volvulus; nonoperative decompression is rarely achievable; and if gangrene supervenes, … Cecal volvulus is second only to sigmoid volvulus in its frequency of occurrence. Diagnostic doubt is not uncommon in cecal volvulus; nonoperative decompression is rarely achievable; and if gangrene supervenes, mortality rises appreciably. Resection is mandatory for gangrene and a grossly distended, thin-walled cecum. Cecopexy and cecostomy seem less-effective and more morbid options than resection and anastomosis for viable bowel. However, their role needs reappraisal in the light of advances in minimally invasive techniques.

Intestinal loop lengthening—A technique for increasing small intestinal length

1980-04-01

A. Bianchi

Laparoscopy during pregnancy: A study of five fetal outcome parameters with use of the Swedish Health Registry

1997-09-01

Mark B. Reedy , Bëngt Källén , Thomas J. Kuehl

Computed tomographic diagnosis of volvulus in intestinal malrotation.

1981-07-01

James K. Fisher

The computed tomographic appearance of volvulus in intestinal malrotation in an adult is presented. The small-bowel loops encircling the superior mesenteric artery create a whirl-like pattern that may be distinctive … The computed tomographic appearance of volvulus in intestinal malrotation in an adult is presented. The small-bowel loops encircling the superior mesenteric artery create a whirl-like pattern that may be distinctive for this diagnosis.

Ultrasound diagnosis of midgut volvulus: the “whirlpool” sign

1992-04-01

J.P. Pracros , L Sann , G. GÉNIN +4 more

Preterm Infants are More Prone to Complications Following Minor Surgery than are Term Infants

1982-04-01

DAVID J. STEWARD

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Intestinal Malrotation in Children: A Problem-solving Approach to the Upper Gastrointestinal Series

2006-09-01

Kimberly E. Applegate , James M. Anderson , Eugene C. Klatte

Intestinal malrotation, which is defined by a congenital abnormal position of the duodenojejunal junction, may lead to midgut volvulus, a potentially life-threatening complication. An evaluation for malrotation is part of … Intestinal malrotation, which is defined by a congenital abnormal position of the duodenojejunal junction, may lead to midgut volvulus, a potentially life-threatening complication. An evaluation for malrotation is part of every upper gastrointestinal (GI) tract examination in pediatric patients, particularly neonates and infants. Although the diagnosis of malrotation is often straightforward, the imaging features in approximately 15% of upper GI tract examinations are equivocal and lead to a false-positive or false-negative interpretation. The clinical manifestations and upper GI tract findings of malrotation in older children and adults are less specific than are those in younger patients, and for this reason diagnosis of the condition may be more difficult. Successful differentiation between a normal variant and malrotation requires the use of optimal techniques in acquiring and interpreting the upper GI series. Familiarity with the upper GI series appearance of both normal and abnormal anatomic variants allows the radiologist to increase both diagnostic accuracy and confidence in the diagnosis of malrotation. © RSNA, 2006

Pathology of neuromuscular disorders of the small intestine and colon

1987-09-01

Shoba Krishnamurthy , Michael D. Schuffler

Pediatric gastrointestinal disease

2005-05-01

Martin H. Ulshen

Disorders of intestinal rotation and fixation (?malrotation?)

2004-09-04

Peter J. Strouse

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Anomalies of intestinal rotation: Their embryology and surgical aspects: With report of five cases

1923-10-01

Norman M. Dott

Journal Article Anomalies of intestinal rotation: Their embryology and surgical aspects: With report of five cases Get access Norman M Dott Norman M Dott Edinburgh Search for other works by … Journal Article Anomalies of intestinal rotation: Their embryology and surgical aspects: With report of five cases Get access Norman M Dott Norman M Dott Edinburgh Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 11, Issue 42, October 1923, Pages 251–286, https://doi.org/10.1002/bjs.1800114207 Published: 06 December 2005

Study of the interstitial cells of Cajal in infantile hypertrophic pyloric stenosis

1996-08-01

JM Vanderwinden , H Liu , MH De Laet +1 more

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Circumumbilical incision for pyloromyotomy

1986-05-01

K C Tan , A. Bianchi

Forty infants with infantile hypertrophic pyloric stenosis had a Ramstedt pyloromyotomy through a circumumbilical incision. Delivery of the pylorus was relatively easy. Mild wound infection occurred in three infants and … Forty infants with infantile hypertrophic pyloric stenosis had a Ramstedt pyloromyotomy through a circumumbilical incision. Delivery of the pylorus was relatively easy. Mild wound infection occurred in three infants and a further child developed a purulent discharge. There was one instance of abdominal wall dehiscence and all the resultant scars were hardly visible, thus achieving an apparently unscarred abdomen.

Intestinal Malrotation in Adolescents and Adults: Spectrum of Clinical and Imaging Features

2002-12-01

Perry J. Pickhardt , Sanjeev Bhalla

Intestinal Malrotation in Adolescents and Adults: Spectrum of Clinical and Imaging FeaturesPerry J. Pickhardt1 2 and Sanjeev Bhalla3Audio Available | Share Intestinal Malrotation in Adolescents and Adults: Spectrum of Clinical and Imaging FeaturesPerry J. Pickhardt1 2 and Sanjeev Bhalla3Audio Available | Share

Colonic Volvulus in the United States

2013-03-22

Wissam J. Halabi , Mehraneh D. Jafari , Celeste Y. Kang +5 more

In Brief Introduction: Colonic volvulus is a rare entity associated with high mortality rates. Most studies come from areas of high endemicity and are limited by small numbers. No studies … In Brief Introduction: Colonic volvulus is a rare entity associated with high mortality rates. Most studies come from areas of high endemicity and are limited by small numbers. No studies have investigated trends, outcomes, and predictors of mortality at the national level. Methods: The Nationwide Inpatient Sample 2002–2010 was retrospectively reviewed for colonic volvulus cases admitted emergently. Patients' demographics, hospital factors, and outcomes of the different procedures were analyzed. The LASSO algorithm for logistic regression was used to build a predictive model for mortality in cases of sigmoid (SV) and cecal volvulus (CV) taking into account preoperative and operative variables. Results: An estimated 3,351,152 cases of bowel obstruction were admitted in the United States over the study period. Colonic volvulus was found to be the cause in 63,749 cases (1.90%). The incidence of CV increased by 5.53% per year whereas the incidence of SV remained stable. SV was more common in elderly males (aged 70 years), African Americans, and patients with diabetes and neuropsychiatric disorders. In contrast, CV was more common in younger females. Nonsurgical decompression alone was used in 17% of cases. Among cases managed surgically, resective procedures were performed in 89% of cases, whereas operative detorsion with or without fixation procedures remained uncommon. Mortality rates were 9.44% for SV, 6.64% for CV, 17% for synchronous CV and SV, and 18% for transverse colon volvulus. The LASSO algorithm identified bowel gangrene and peritonitis, coagulopathy, age, the use of stoma, and chronic kidney disease as strong predictors of mortality. Conclusions: Colonic volvulus is a rare cause of bowel obstruction in the United States and is associated with high mortality rates. CV and SV affect different populations and the incidence of CV is on the rise. The presence of bowel gangrene and coagulopathy strongly predicts mortality, suggesting that prompt diagnosis and management are essential. Colonic volvulus is a rare cause of bowel obstruction in the United States. Cecal and sigmoid volvulus affect different populations. Although the incidence of cecal volvulus is increasing, that of sigmoid volvulus remains stable. Mortality rates after operation for volvulus are predicted by bowel viability, coagulopathy, and renal failure.

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Volvulus of the Gastrointestinal Tract: Appearances at Multimodality Imaging

2009-09-01

Christine Peterson , Jane Anderson , Amy K. Hara +2 more

Volvulus of the gastrointestinal tract, a clinically relevant cause of acute or recurring abdominal pain in adults, remains a diagnostic dilemma for radiologists in a large number of cases. The … Volvulus of the gastrointestinal tract, a clinically relevant cause of acute or recurring abdominal pain in adults, remains a diagnostic dilemma for radiologists in a large number of cases. The clinical symptoms associated with volvulus are often nonspecific and include pain and nausea with vomiting. Yet referring clinicians often rely on radiologists to make the diagnosis; volvulus is rarely diagnosed clinically. Radiography, fluoroscopy, and computed tomography are the imaging methods most often used for this purpose. Prompt diagnosis is critical to avoid life-threatening complications such as bowel ischemia and infarction. Thus, it is useful for radiologists to be familiar with the various appearances of volvulus throughout the gastrointestinal tract. © RSNA, 2009

Pseudotachylyte controversy: Fact or friction?

1995-01-01

J. G. Spray

Research Article| December 01, 1995 Pseudotachylyte controversy: Fact or friction? John G. Spray John G. Spray 1Department of Geology, University of New Brunswick, Fredericton, New Brunswick E3B 5A3, Canada Search … Research Article| December 01, 1995 Pseudotachylyte controversy: Fact or friction? John G. Spray John G. Spray 1Department of Geology, University of New Brunswick, Fredericton, New Brunswick E3B 5A3, Canada Search for other works by this author on: GSW Google Scholar Author and Article Information John G. Spray 1Department of Geology, University of New Brunswick, Fredericton, New Brunswick E3B 5A3, Canada Publisher: Geological Society of America First Online: 02 Jun 2017 Online ISSN: 1943-2682 Print ISSN: 0091-7613 Geological Society of America Geology (1995) 23 (12): 1119–1122. https://doi.org/10.1130/0091-7613(1995)023<1119:PCFOF>2.3.CO;2 Article history First Online: 02 Jun 2017 Cite View This Citation Add to Citation Manager Share Icon Share Facebook Twitter LinkedIn Email Permissions Search Site Citation John G. Spray; Pseudotachylyte controversy: Fact or friction?. Geology 1995;; 23 (12): 1119–1122. doi: https://doi.org/10.1130/0091-7613(1995)023<1119:PCFOF>2.3.CO;2 Download citation file: Ris (Zotero) Refmanager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentBy SocietyGeology Search Advanced Search Abstract High-speed slip experiments performed on Westerly granite using friction welding apparatus reveal that comminution is an essential precursor to melting by friction. Observations of slip surfaces via analytical scanning electron microscopy (SEM) document the following sequence of events occurring in 2 s with increasing velocity (up to 2 m/s): fracture; progressive comminution; surface melting of mineral fragments; fragment-to-fragment adhesion; and, finally, production of a fragment-laden, melt-supported suspension. Explosive dehydration and melting of the epidote-group mineral allanite indicates that temperatures of at least 1000 °C were realized at the interface. This is corroborated by calculation of the temperature rise for the known operating conditions. Contrary to earlier proposals, these results show that comminution and frictional melting are complementary and not mutually exclusive processes. Depending on the velocity–shear stress–displacement relations prevailing during frictional slip, rocks produced in seismogenic zones can be predominantly comminuted wall rock or fragment-melt mixes (pseudotachylytes). This content is PDF only. Please click on the PDF icon to access. First Page Preview Close Modal You do not have access to this content, please speak to your institutional administrator if you feel you should have access.

Congenital Anomalies of the Small Intestine, Colon, and Rectum

1999-09-01

Teresa Berrocal , Manuel López‐Rivadulla , J Gutieérrez +3 more

Congenital anomalies of the gastrointestinal tract are a significant cause of morbidity in children and, less frequently, in adults. These abnormalities include developmental obstructive defects of the small intestine, anomalies … Congenital anomalies of the gastrointestinal tract are a significant cause of morbidity in children and, less frequently, in adults. These abnormalities include developmental obstructive defects of the small intestine, anomalies of the colon, anomalies of rotation and fixation, anorectal anomalies, and intestinal duplications. Neonates with complete high intestinal obstruction do not usually require further radiologic evaluation following radiography, whereas those with complete low obstruction should undergo a contrast material enema examination. An upper gastrointestinal series must be performed in all patients with incomplete intestinal obstruction because management is different in each case. In low intestinal obstruction, ultrasonography (US) may help differentiate between small bowel obstruction and colonic obstruction. In addition, US can help correctly identify meconium ileus and meconium peritonitis and is useful in the diagnosis of enteric duplication cysts. In malrotation and anorectal anomalies, computed tomography (CT) and magnetic resonance (MR) imaging can provide superb anatomic detail and added diagnostic specificity. Intestinal duplications manifest as an abdominal mass at radiography, contrast enema examination, or US. At CT, most duplications manifest as smoothly rounded, fluid-filled cysts or tubular structures with thin, slightly enhancing walls. At MR imaging, the intracystic fluid has heterogeneous signal intensity on T1-weighted images and homogeneous high signal intensity on T2-weighted images. Familiarity with these gastrointestinal abnormalities is essential for correct diagnosis and appropriate management.

Small intestinal length: a factor essential for gut adaptation.

1991-11-01

Lawrence T. Weaver , Steve Austin , Tim Cole

Changes in small intestinal structure, cytokinetics, and function are dynamic ways in which the gut adapts to diet, disease, and damage. Adequate length provides a static 'reserve' permitting an immediate … Changes in small intestinal structure, cytokinetics, and function are dynamic ways in which the gut adapts to diet, disease, and damage. Adequate length provides a static 'reserve' permitting an immediate response to pathophysiological changes. The length of the small intestine from conception to adulthood using data taken from eight published reports of necropsy measurement of 1010 guts is described. Mean length at 20 weeks' gestation was 125 cm, at 30 weeks' 200 cm, at term 275 cm, at 1 year 380 cm, at 5 years 450 cm, at 10 years 500 cm, and at 20 years 575 cm. Prenatal small intestinal growth exceeded that of body length according to the law: small intestinal length alpha body length to the power 4/3. After birth there was a noticeable deceleration: small intestinal length alpha body length to the power 1/2. The coefficient of variation of small intestinal length postnatally was 24%, sixfold greater than for body length. The rapid prenatal small intestinal growth rate ensures that the mature newborn has adequate small intestine to meet postnatal nutritional demands, but handicaps the preterm infant who undergoes intestinal resection. The wide variation in lengths suggests a 'surplus' surface area that is immediately available to respond, independent of dynamic mucosal changes, to fluctuations in food availability, local intestinal disease, damage, rapid transit, and resection.

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The classification of cancer of the rectum

1932-01-01

Cuthbert Dukes

Neostigmine for the Treatment of Acute Colonic Pseudo-Obstruction

1999-07-15

Robert J. Ponec , Michael D. Saunders , Michael B. Kimmey

Acute colonic pseudo-obstruction -- that is, massive dilation of the colon without mechanical obstruction -- may develop after surgery or severe illness. Although it may resolve with conservative therapy, colonoscopic … Acute colonic pseudo-obstruction -- that is, massive dilation of the colon without mechanical obstruction -- may develop after surgery or severe illness. Although it may resolve with conservative therapy, colonoscopic decompression is sometimes needed to prevent ischemia and perforation of the bowel. Uncontrolled studies have suggested that neostigmine, may be an effective treatment.We studied 21 patients with acute colonic pseudo-obstruction. All had abdominal distention and radiographic evidence of colonic dilation, with a cecal diameter of at least 10 cm, and had had no response to at least 24 hours of conservative treatment. We randomly assigned 11 to receive 2.0 mg of neostigmine intravenously and 10 to receive intravenous saline. A physician who was unaware of the patients' treatment assignments recorded clinical response (defined as prompt evacuation of flatus or stool and a reduction in abdominal distention), abdominal circumference, and measurements of the colon on radiographs. Patients who had no response to the initial injection were eligible to receive open-label neostigmine three hours later.Ten of the 11 patients who received neostigmine had prompt colonic decompression, as compared with none of the 10 patients who received placebo (P<0.001). The median time to response was 4 minutes (range, 3 to 30). Seven patients in the placebo group and the one patient in the neostigmine group without an initial response received open-label neostigmine; all had colonic decompression. Two patients who had an initial response to neostigmine required colonoscopic decompression for recurrence of colonic distention; one eventually underwent subtotal colectomy. Side effects of neostigmine included abdominal pain, excess salivation, and vomiting. Symptomatic bradycardia developed in two patients and was treated with atropine.In patients with acute colonic pseudo-obstruction who have not had a response to conservative therapy, treatment with neostigmine rapidly decompresses the colon.

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THE INHERITANCE OF CONGENITAL PYLORIC STENOSIS

1961-09-01

C. O. CARTER

Journal Article THE INHERITANCE OF CONGENITAL PYLORIC STENOSIS Get access C. O. CARTER, B.A. B.M. M.R.C.P. C. O. CARTER, B.A. B.M. M.R.C.P. Medical Research Council Clinical Genetics Research Unit Institute … Journal Article THE INHERITANCE OF CONGENITAL PYLORIC STENOSIS Get access C. O. CARTER, B.A. B.M. M.R.C.P. C. O. CARTER, B.A. B.M. M.R.C.P. Medical Research Council Clinical Genetics Research Unit Institute of Child Health The Hospital for Sick ChildrenLondon Search for other works by this author on: Oxford Academic PubMed Google Scholar British Medical Bulletin, Volume 17, Issue 3, September 1961, Pages 251–253, https://doi.org/10.1093/oxfordjournals.bmb.a069918 Published: 01 September 1961

Abdominal Surgery of Infancy and Childhood

1941-12-13

1. General Management Considerations 2. The Alimentary Tract in Newborns 3. The Alimentary Tract in Older Infants and Children 4. The Liver, Biliary Tract, Pancreas, Spleen and Adrenal Glands 5. … 1. General Management Considerations 2. The Alimentary Tract in Newborns 3. The Alimentary Tract in Older Infants and Children 4. The Liver, Biliary Tract, Pancreas, Spleen and Adrenal Glands 5. Abdominal Tumours 6. Abdominal Trauma

GASTRECTOMIA TOTAL, PARCIAL, PROXIMAL E SEGMENTAR: TÉCNICAS CIRÚRGICAS E ESCOLHA TERAPÊUTICA

2025-06-24

NICOLAS DE CESARO SCHPCHACKI , YAN DE SOUZA CARVALHO , PEDRO MALFUSSI HORST +7 more | Editora Pasteur eBooks

Crossed fused renal ectopia and Chilaiditi syndrome

2025-06-24

Farah Alyetama | Radiopaedia.org

Imaging features of cecal volvulus complicating a complete common mesentery: A case report

2025-06-21

Annette R. Khaled , Nizar El Bouardi , Zaid Ennasery +7 more | Radiology Case Reports

Chronic diarrhea as an atypical presentation of complete common mesentery in an adult: A case report

2025-06-21

CHAIMAE HADDAD HACHIMI , Mouna Tamzaourte , N. Mahassini +2 more | International Journal of Science and Research Archive

Complete common mesentery (CCM) is a rare congenital anomaly of intestinal rotation, typically discovered incidentally or during acute abdominal events. Chronic gastrointestinal symptoms, such as persistent diarrhea, have not been … Complete common mesentery (CCM) is a rare congenital anomaly of intestinal rotation, typically discovered incidentally or during acute abdominal events. Chronic gastrointestinal symptoms, such as persistent diarrhea, have not been previously described as a presenting sign. We report the case of a 56-years-old female with chronic diarrhea and mild abdominal discomfort. Imaging revealed a complete common mesentery. The patient was managed conservatively with symptom improvement. CCM is usually asymptomatic or presents with acute complications such as volvulus or left-sided appendicitis. This case highlights the possibility of chronic functional gastrointestinal manifestations due to congenital anatomical anomalies. We discuss the embryological background, diagnostic imaging, clinical presentations, and therapeutic considerations. In cases of unexplained chronic diarrhea, clinicians should consider rare anatomical variants like CCM, particularly when standard diagnostic approaches are unrevealing.

Prophylactic Antibiotic use and Outcomes in Infants Undergoing Pyloromyotomy

2025-06-20

Kerri McKie , Anoosha Moturu , Dionne A. Graham +7 more | Annals of Surgery

Objective: To compare outcomes in infants undergoing pyloromyotomy who did and did not receive antimicrobial prophylaxis. Summary Background Data: Variation exists among pediatric surgeons in the perceived utility and use … Objective: To compare outcomes in infants undergoing pyloromyotomy who did and did not receive antimicrobial prophylaxis. Summary Background Data: Variation exists among pediatric surgeons in the perceived utility and use of prophylactic antibiotics for infants undergoing pyloromyotomy. Methods: We conducted a multicenter study of infants undergoing pyloromyotomy at 148 hospitals participating in NSQIP-Pediatric from January 2021 to December 2023. Outcomes were compared using patient-level propensity-matched mixed-effects models, adjusting for hospital clustering. A complementary hospital-level analysis assessed the correlation between institutional prophylaxis rates and observed-to-expected (O/E) surgical site infection (SSI) rate ratios. Results: 6093 infants were included, of which 46.6% received prophylaxis. In the propensity-matched analysis, outcomes were similar for SSI (no prophylaxis: 38/2591 [1.6%] vs. prophylaxis: 28/2591 [1.1%], aOR 0.61; 95% CI, 0.37–1.01) and higher rates of prophylaxis use were not correlated with lower SSI O/E rate ratios in the hospital-level analysis (Spearman ρ = 0.11; P = 0.13). In propensity-matched subgroup analyses stratified by operative approach, no benefit was observed in the use of prophylaxis in infants undergoing laparoscopic pyloromyotomy (prophylaxis: 24/2288 [1.1%] vs. no prophylaxis: 25/2288 [1.1%]; aOR, 0.96; 95% CI, 0.55–1.69); however, a significant reduction in SSI rates was observed with open repair (prophylaxis: 6/311 [1.9%] vs. no prophylaxis: 16/311 [5.1%]; aOR 0.36; 95% CI, 0.14–0.93). Conclusions: Routine prophylaxis use does not reduce SSI rates in infants undergoing laparoscopic pyloromyotomy; however, a significant reduction in SSI was observed in infants undergoing open repair, suggesting selective prophylaxis is indicated in this higher-risk cohort.

Volvulus of the Transverse Colon: A Report of Two Cases and Review of Literature

2025-06-18

Mohamed A. Ahmed , Ahmed Allawi , Sarmad Mohammed Salih +2 more | Cureus

Advanced endoscopic technique for treating antral web in pediatrics: A case series.

2025-06-18

Byron Pascual Campoverde Arévalo , Jessica Perez Zempoalteca , Ángeles Cristina Iza Velastegui +1 more | Acta Pediátrica de México

BACKGROUND: Antral web is an uncommon anomaly in pediatrics, characterized by a membranous relic vestige that can be a significant cause of gastric outlet obstruction. This condition can lead to … BACKGROUND: Antral web is an uncommon anomaly in pediatrics, characterized by a membranous relic vestige that can be a significant cause of gastric outlet obstruction. This condition can lead to misdiagnosis or delayed diagnosis due to clinical manifestations of food intolerance, non-biliary emesis, epigastric pain, that mirror other pathologies such as pyloric stenosis, gastroesophageal reflux, and peptic ulcer. Typically, treatment for this pathology is surgical intervention; however, four case reports are presented describing management through a less invasive endoscopic technique. CASE REPORTS: Four cases involving two children aged 2 years, 10 years, and 3 years are described. These cases presented inconclusive clinical data, leading to an upper endoscopy that revealed the presence of a web in the antral and prepyloric regions. Therefore, an outpatient and less invasive management option through endoscopic web resection is presented involving an incision with a sphincterotome followed by dilation with a hydrostatic balloon. CONCLUSIONS: Antral web should be considered in pediatric patients exhibiting gastric outlet obstruction symptoms. Once diagnosed, treatment can be carried out through an endoscopic web resection. However, there are limitations to this approach, as some membranes may reoccur, leading to re-stenosis, and then open surgery should be considered.

A Rare Case of Apple Peel Ileal Atresia With Coexisting Colonic Atresia: Surgical Management and Outcomes

2025-06-18

Aleksandra I Sadecka , Aleksandra Jasińska | Cureus

Ileal atresia is one of the most frequent causes of congenital intestinal obstruction. Type IIIb, also known as apple peel atresia, is the least common subtype. Colonic atresia is a … Ileal atresia is one of the most frequent causes of congenital intestinal obstruction. Type IIIb, also known as apple peel atresia, is the least common subtype. Colonic atresia is a rare anomaly that can also cause neonatal intestinal obstruction. Both can coexist with other atypical malformations, further complicating diagnosis. The surgical management of these two gastrointestinal malformations differs between centers, and no standardized procedural guidelines currently exist. We present a case of a neonate born with apple peel ileal atresia coexisting with transverse colonic atresia, both successfully treated with primary anastomoses. The postoperative course was uneventful, and the patient was discharged with full oral feeding and regular bowel movements.

Survival outcomes in patients with sigmoid volvulus

2025-06-17

R Bock , P G Vaughan-Shaw , A. J. Clark +7 more | International Journal of Colorectal Disease

Diffuse Bowel Dilation as a Novel Diagnostic Marker for Jejunoileal Atresias: A Machine Learning Approach Integrating Risk Factors

2025-06-16

Qi Li , Yang Li , Jingwei Liu +3 more | Research Square (Research Square)

<title>Abstract</title> Background Jejunoileal atresias (JIA) are congenital intestinal obstructions with a complex etiology, where timely surgery is crucial but prenatal diagnosis is challenging due to overlapping ultrasound signs with other … <title>Abstract</title> Background Jejunoileal atresias (JIA) are congenital intestinal obstructions with a complex etiology, where timely surgery is crucial but prenatal diagnosis is challenging due to overlapping ultrasound signs with other disorders. This study aimed to identify key prenatal ultrasound and clinical predictors of JIA in fetuses with bowel dilation, with a focus on novel morphological markers. Methods We performed a retrospective analysis of cases from From January 1, 2018, to November 15, 2024, with fetal bowel dilation. Demographic information and ultrasound data were collected. The Lasso-logit model was employed to screen the final variables. Moreover, the marginal propensity diagrams were utilized to visually display the change in the probability of JIA occurrence with the variation of these variables. Results Dilation type, polyhydramnios, and bowel diameter were primary explanatory variables in the model, with odds ratios of 320.86, 108.85, and 55.09 respectively. JIA probability exceeds 50% when the normalized bowel diameter reaches 1.1 (about 34.4 mm actual diameter).With a specific bowel diameter, JIA probability is highest when both diffuse dilation and polyhydramnios exist, followed by only diffuse dilation, and lowest without both. Conclusions Diffuse bowel dilation, larger bowel diameter, and polyhydramnios are critical ultrasound markers for JIA. The proposed Lasso-Logit model highlights diffuse dilation as a novel, independent diagnostic criterion, addressing gaps in prenatal specificity.

Diagnosis and Treatment of Hypermobile Cecum Mimicking Acute Appendicitis

2025-06-16

Ahmed M. Hassan | Cureus

Small bowel volvulus induced by cystic lymphangioma in a 12-year-old child: Case report

2025-06-14

Amal Mojahid , Hicham Benramdane , Nadia El Mahi +4 more | Radiology Case Reports

Management of Pancreatectomy for Pancreatic Cancer in a Patient With Annular Portal Pancreas: A Case Report

2025-06-13

Hiroyuki Hakoda , Koichiro Kawasaki , Kiyohiko Omichi +3 more | Cureus

Same‐Day Discharge, Medical and Non‐Medical Admission After Per‐Oral Endoscopic Pyloromyotomy

2025-06-12

Brittany Pass , Michelle Neice , Karan Sachdeva +7 more | Journal of Digestive Diseases

ABSTRACT Objectives Gastric per‐oral endoscopic myotomy (G‐POEM) is a promising treatment for gastroparesis. Our previous pilot study has indicated that about 50% of patients could be safely discharged home on … ABSTRACT Objectives Gastric per‐oral endoscopic myotomy (G‐POEM) is a promising treatment for gastroparesis. Our previous pilot study has indicated that about 50% of patients could be safely discharged home on the same day as the procedure. In this study, we presented more data on this topic and divided admission into medical and non‐medical admissions to assess the safety of same‐day discharge after the G‐POEM procedure. Methods All patients who underwent G‐POEM for gastroparesis at our institution from April 2022 to June 2023 were included. After undergoing G‐POEM, patients who met the following four criteria would be discharged on the same day: (i) no major complications during the procedure; (ii) patient having abdominal pain scored 4 or less on a pain scale from 0 to 10, or > 4 but improved after having one dose of intravenous pain medication; (iii) no vomiting after the procedure; and (iv) the patient had someone at home to help them access medical care when necessary. The admitted patients were divided into two groups: those with medical issues, and those with non‐medical issues. Results Altogether 61 consecutive patients were included in this study, among whom 40 (65.6%) were discharged on the same day. Among the 21 (34.4%) patients who were admitted to the hospital for observation, 12 were admitted for non‐medical issues. The remaining nine (14.8%) patients were admitted for medical issues. Conclusions After about 10 years of practice, G‐POEM is a safe endoscopic therapeutic modality. This study shows that 85.2% of patients undergoing G‐POEM can be discharged on the same day.

Successful Endoscopic Management of Gastric Volvulus: A Case Report Highlighting Effective Treatment Strategies.

2025-06-12

T Halbart , Calliope Maris , S. Laurent +3 more | PubMed

Gastric volvulus is a rare entity which lacks evidence in the literature, characterized by the abnormal twisting or rotation of the stomach on itself of at least 180 degrees along … Gastric volvulus is a rare entity which lacks evidence in the literature, characterized by the abnormal twisting or rotation of the stomach on itself of at least 180 degrees along its transverse or longitudinal axis. This rotation can lead to the obstruction of the stomach and interfere with its blood supply, causing a variety of symptoms and potentially serious complications. Some patients may be managed temporarily or definitively with conservative or endoscopic treatment, the latest including reduction and percutaneous gastropexy, but most patients benefit from surgery. The authors report three cases of gastric volvulus seen in a six-months period.

Outcome of Laparoscopic versus Open Pyloromyotomy in Treatment of Infantile Hypertrophic Pyloric Stenosis

2025-06-12

Mushkbar Naeem | Journal of the Dow University of Health Sciences

Wandering spleen and intestinal malrotation in a 14-year-old female: a case report

2025-06-01

M Amine , Mrani Alaoui Nidal , Y. Zaoui +2 more | Journal of Pediatric Surgery Case Reports

Unexpected midgut malrotation during laparoscopic Roux-en-Y gastric bypass: A rare East Asian case and surgical considerations

2025-06-01

Joseph H. Chang , Po‐Chih Chang , Ting‐Wei Chang | Asian Journal of Surgery

Sigmoid and cecal volvulus in pregnancy and puerperium: A systematic review

2025-05-29

Goran Augustin , Zlatko Hrgović , Ante Tavra +3 more | World Journal of Gastrointestinal Surgery

BACKGROUND Cecal and sigmoid volvulus during pregnancy are extremely rare. Symptoms of intestinal obstruction in pregnancy make accurate clinical diagnosis challenging. AIM To identify predictive factors for early diagnosis and … BACKGROUND Cecal and sigmoid volvulus during pregnancy are extremely rare. Symptoms of intestinal obstruction in pregnancy make accurate clinical diagnosis challenging. AIM To identify predictive factors for early diagnosis and successful treatment and an association between the diagnosis and maternal/neonatal outcomes. METHODS A systematic review of human studies (PubMed, PubMedCentral, Google Scholar) up to October 2024 was conducted per PRISMA guidelines. Data on demographics, clinical features, diagnostics, treatment, and outcomes were analyzed. RESULTS Antepartum and postpartum volvulus occurred in 75.5% and 24.5% of cases, respectively, most commonly in the third trimester (70.3%). Nausea was less frequent and obstipation was more common in sigmoid volvulus (P = 0.0004). Endoscopic detorsion was successful in 23.9% of sigmoid cases, with a mean gestational age of 33.5 ± 3.5 weeks. Maternal mortality was 12.5% for cecal and 5.5% for sigmoid volvulus (P = 0.103). While maternal mortality was unaffected by the timing of delivery relative to surgery, fetal mortality was significantly higher when the interval was < 24 hours (52.9% vs 10.4%, P < 0.001). Both maternal and fetal mortality declined over time. CONCLUSION Constipation was a risk factor for sigmoid volvulus and prior open appendectomy for cecal volvulus. Endoscopy was more often used in sigmoid cases. Gestational age and maternal age did not affect fetal outcomes. Earlier imaging and appropriate surgery were linked to lower mortality. Delay > 24 hours between intervention and delivery increased fetal, but not maternal mortality. Successful endoscopic detorsion eliminated maternal mortality and significantly lowered fetal mortality.

A Rare Case of Type II Adult Hypertrophic Pyloric Stenosis Secondary to Chronic Peptic Ulcer Disease

2025-05-29

Regent Lee , Sylvia Dygulski , Yasmine Hemida +1 more | Cureus

Abnormal anatomical landmarks: the guide points of laparoscopic Ladd’s surgery for neonatal congenital intestinal malrotation

2025-05-29

Xinhao Zeng , Ni Lian , Xiaoyong Wang +1 more | Surgical Endoscopy

Laparotomía de urgencia por peritonitis primaria en paciente pediátrico previamente sano: reporte de caso

2025-05-28

Jéshua Wandherley Dos santos Ramírez | Investigación e Innovación Clínica y Quirúrgica Pediátrica

Gran parte de los pacientes que presentan peritonitis de inicio súbito tienen alguna causa secundaria como apendicitis aguda o perforación intestinal. La peritonitis primaria es una patología extremamente inusual como … Gran parte de los pacientes que presentan peritonitis de inicio súbito tienen alguna causa secundaria como apendicitis aguda o perforación intestinal. La peritonitis primaria es una patología extremamente inusual como causa de abdomen agudo, siendo menos del 1-2%. En pacientes pediátricos, la presentación clínica puede ser similar a un cuadro de peritonitis secundaria y requerir intervención quirúrgica. Se presenta el caso de una paciente pediátrica con peritonitis primaria con signos y síntomas semejantes a la apendicitis aguda, que fue intervenida mediante laparotomía exploratoria, la cual no fue terapéutica, ya que no se encontró causa secundaria de peritonitis. Este caso discute la utilidad de la cirugía abierta en estos pacientes o si existen mejores alternativas del manejo preoperatorio, principalmente en centros de salud con recursos limitados donde no se dispone de estudios de imagen disponibles o instrumental para cirugía laparoscópica

Twenty Years Experience of Bell’s Stage 3b Necrotizing Enterocolitis—A Single Center Study

2025-05-27

Mohammed Shahnawaz Ansari , Saroja Balan , Vidya S. Gupta +1 more

Objective To analyze 20 years of experience of Bell’s stage 3b necrotizing enterocolitis (NEC) from a single center. Methods A total of 57 Bell’s stage 3b NEC cases were included … Objective To analyze 20 years of experience of Bell’s stage 3b necrotizing enterocolitis (NEC) from a single center. Methods A total of 57 Bell’s stage 3b NEC cases were included in this study. The clinical records, operative findings, and outcomes of babies admitted to the neonatal intensive care unit (NICU) were tabulated and recorded retrospectively in the EXCEL database. All deaths and leaves against medical advice were recorded, and clinical outcomes at day 30 and 1 year post-operative were recorded. Results The mean gestational age (GA) and mean birth weight of the mortality group were 30 ± 3.5 weeks and 1.105 ± 0.479 kg, respectively. The most common surgery performed in the mortality group was subtotal colectomy with ileostomy (31%). The day 30 (D30) and 1 year (D365) post-operative mortality were 24.5% and 28%, respectively. The most common complication post-surgery was short bowel syndrome (100%) and failure to thrive (43.9%). Klebsiella was the most common growth in blood culture in both survivor and mortality groups. After 1 year, 14.2% had moderate to severe, and 4.76% had mild developmental delay as per the Development Assessment Scale for Indian Infants (DASII), despite several days of ventilator requirement with inotropes in almost all babies. At the end of 1 year, 72% of babies who underwent surgery for this common, disastrous emergency in neonatal practice were alive and thriving. Conclusion This study reflects the outcome of severe NEC from an Indian university teaching center in neonatology and compares favorably with several landmark articles from the Western world.

Taurus Philtrum: A Newly Identified Phenomenon in Overfilled Syndrome

2025-05-27

Ivan Wong , A. S. Sydorchuk , Kyu‐Ho Yi

Chilaiditi sign

2025-05-27

Aiah Al-Saig

Membranas Duodenales: Un Desafío Diagnóstico y Quirúrgico en Pediatría, Reporte de un Caso

2025-05-26

María Belén Espinosa Morales , Pedro David Méndez Cordero , Isabel María Salcedo Velarde +2 more | Ciencia Latina Revista Científica Multidisciplinar

Las membranas duodenales son una anomalía rara y desafiante en pediatría, que puede presentar un reto diagnóstico significativo debido a su presentación clínica variable. Este informe de caso describe a … Las membranas duodenales son una anomalía rara y desafiante en pediatría, que puede presentar un reto diagnóstico significativo debido a su presentación clínica variable. Este informe de caso describe a un paciente pediátrico con una obstrucción intestinal alta, cuyos síntomas iniciales fueron inespecíficos, lo que dificultó un diagnóstico temprano. La evaluación clínica y las pruebas de imágenes no fueron concluyentes, lo que llevó a un retraso en el diagnóstico definitivo. La sospecha clínica aumentó cuando la obstrucción persistió a pesar de las intervenciones iniciales, lo que motivó la realización de una endoscopia superior y una cirugía exploratoria. Durante la intervención quirúrgica, se identificó una membrana duodenal que causaba una obstrucción completa del tránsito intestinal. Tras la resección de la membrana, el paciente mostró una rápida mejoría clínica y fue dado de alta sin complicaciones. Este caso resalta la importancia de considerar la membrana duodenal como un diagnóstico diferencial en niños con síntomas de obstrucción intestinal, especialmente cuando las pruebas iniciales no ofrecen respuestas claras. La incidencia de membranas duodenales en pediatría es baja, pero su diagnóstico temprano y manejo quirúrgico adecuado son fundamentales para prevenir complicaciones graves. Este reporte subraya la necesidad de un enfoque diagnóstico exhaustivo y de mantener un alto índice de sospecha en los casos clínicos complicados, para asegurar una intervención oportuna y mejorar el pronóstico del paciente.