91 results match your criteria volvulus challenging

Caecal volvulus and jejunostomy: challenging diagnostic.

J Surg Case Rep 2021 Apr 24;2021(4):rjab148. Epub 2021 Apr 24.

General Surgery Department, Hospital del Mar, Barcelona, Spain.

Caecal volvulus represent the 20-40% of colonic volvulus, being the second most frequent localization. It causes intestinal occlusion symptomatology (nausea, vomiting, abdominal distension). We present a case of 45-year-old women with feeding jejunostomy tube due to connatal anoxia. Read More

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Gastric remnant mesentero-axial volvulus following Roux-en-Y esophagojejunostomy: A rare complication.

Int J Surg Case Rep 2021 May 7;82:105873. Epub 2021 Apr 7.

Esophageal Institute, Allegheny Health Network, Pittsburgh, PA, United States. Electronic address:

Introduction: Acute gastric volvulus is a surgical emergency with a mortality as high as 15-20%. The rarity of gastric volvulus requires high index of clinical suspicion especially in the patients with altered anatomy, to allow immediate surgical intervention and reduce the morbidity and mortality.

Presentation Of Case: We present an unusual case of gastric remnant volvulus several months following Roux-en-Y esophagojejunostomy performed in an obese patient for severe, recurrent gastroesophageal reflux disease (GERD) and failed prior fundoplication. Read More

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Sentinel bowel loop as a marker for primary segmental intestinal volvulus in extreme low birth weight neonates.

J Neonatal Perinatal Med 2021 Mar 16. Epub 2021 Mar 16.

Division of Pediatric Surgery and Urology, University of Maryland Medical Center, Baltimore, USA.

Primary segmental intestinal volvulus is a rare condition that may affect neonates. This condition occurs when a loop of bowel torses around the axis of its mesentery without any other abnormality or malrotation. In the earlier stages, the diagnosis can be challenging due to the lack of specific clinical and radiographic signs. Read More

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Caecal volvulus on a background of recurrent caecocolic torsion.

Ann R Coll Surg Engl 2021 May 8;103(5):e177-e179. Epub 2021 Mar 8.

Imperial Healthcare NHS Trust, UK.

Caecal volvulus is an uncommon cause of intestinal obstruction. Diagnosis may be challenging due to lack of clinical familiarity, variable clinical presentation and misinterpretation of diagnostic imaging and procedures. This case report describes a 29-year-old male with acute intestinal obstruction secondary to caecal volvulus, on a background of recurrent caecocolic torsion. Read More

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The diagnostic dilemma of a gallbladder volvulus: An unusual case report and review of the literature.

Int J Surg Case Rep 2021 Mar 3;80:105614. Epub 2021 Feb 3.

Department of Surgery, University of Saskatchewan, Saskatoon, Canada; Professor of Surgery, University of Saskatchewan, Saskatoon, Canada.

Introduction And Importance: A gallbladder volvulus is a rare medical condition requiring emergency surgery. There are 500 cases reported in the literature, and only 10 % have ever been diagnosed preoperatively. Gallbladder volvulus occurs when the gallbladder torts around the cystic duct and cystic artery resulting in occlusion of both structures and consequently, ischemia of the gallbladder. Read More

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Uncomplicated Sigmoid Volvulus Is Ideal for Laparoscopic Sigmoidectomy With Transrectal Natural Orifice Specimen Extraction.

Dis Colon Rectum 2021 May;64(5):e90-e93

1 Department of Colorectal Surgery, Singapore General Hospital, Singapore 2 Division of Colorectal Surgery, China Medical University Hospital, Taichung, Taiwan 3 Division of Colorectal Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan.

Introduction: Natural orifice specimen extraction is the next step in minimally invasive colorectal surgery but can be technically challenging, with additional risks, especially for oncologic surgery. For several key reasons, sigmoid volvulus is well suited for natural orifice specimen extraction surgery. We describe our method and experience with double-stapled anastomosis transrectal natural orifice specimen extraction for sigmoid volvulus. Read More

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Natural orifice specimen extraction for colorectal surgery: Early adoption in a Western population.

Colorectal Dis 2021 Apr 20;23(4):937-943. Epub 2020 Dec 20.

Macquarie University, North Ryde, NSW, Australia.

Aim: Natural orifice specimen extraction (NOSE) challenges the limits of minimally invasive colorectal surgery by exploiting a natural opening for specimen delivery. Technically challenging, it is less painful, requires smaller wounds and abolishes the possibility of incisional hernia. These advantages of NOSE are seen in the obese (body mass index [BMI] >30 kg/m ). Read More

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Large bowel obstruction as a consequence of transverse colon volvulus: A case report.

Int J Surg Case Rep 2020 21;76:534-538. Epub 2020 Oct 21.

Department of Nursing, Jordanian Royal Medical Services (JRMS), Amman, Jordan. Electronic address:

Introduction: Transverse colon volvulus incidence is comparatively rare when compared to cecal and sigmoid volvulus. Its diagnosis is still challenging for the surgeon. Delay in the diagnosis of this condition carries high morbidity and mortality rates. Read More

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October 2020

Caecal volvulus in an incisional hernia.

J Surg Case Rep 2020 Oct 31;2020(10):rjaa422. Epub 2020 Oct 31.

Department of Surgery, The Queen Elizabeth Hospital, Woodville South, Australia.

Caecal volvulus represents 25-40% of all colonic volvulus. Symptoms include abdominal distension, constipation, nausea and vomiting where it may be intermittent. Abdominal X-rays and computed tomography (CTs) may help with diagnosis and recommended treatment is resection of mobile caecum. Read More

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October 2020

An ovarian torsion in a 2-year-old girl: a case report.

J Med Case Rep 2020 Oct 18;14(1):194. Epub 2020 Oct 18.

Teaching Hospital, Karapitiya, Galle, Sri Lanka.

Background: Abdominal pain is one of the most common complaints by patients in the emergency department. Diarrhea, constipation, and urinary tract infection are the commonest etiologies among these patients, but there are surgical emergencies, such as appendicitis and volvulus of the intestine, which are less common. Torsion of the ovary is rarer than all of the above conditions. Read More

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October 2020

A Challenging Case of Ileosigmoid Knotting in an Elderly.

Cureus 2020 Aug 9;12(8):e9624. Epub 2020 Aug 9.

General Surgery, All India Institute of Medical Sciences, Bhubaneswar, IND.

Ileosigmoid knotting (ISK) is one of the rare causes of acute intestinal obstruction, which has a rapid course for forming gangrene. ISK is considered a variant of sigmoid volvulus, which otherwise is called compound volvulus. The difficulty in ISK diagnoses is owing to its rarity, uncommon presentation, and non-specific radiological findings. Read More

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Wandering Spleen Volvulus: A Case Report and Literature Review of This Diagnostic Challenge.

Am J Case Rep 2020 Sep 1;21:e925301. Epub 2020 Sep 1.

Department of General Surgery, Hospital of Valais (CHVR), Sion, Switzerland.

BACKGROUND Wandering spleen is a rare condition in which the spleen lacks the usual peritoneal attachments, resulting in increased intra-abdominal mobility. Complications can occur due to the torsion of the splenic vascular pedicle, resulting in symptoms ranging from an incidental finding to an acute abdomen as a result of an ischemic necrosis of the spleen. CASE REPORT We present the case of a 25-year-old female patient who presented with a recurring abdominal pain associated with serum lipase and C-reactive protein elevation. Read More

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September 2020

The natural course of giant paraesophageal hernia and long-term outcomes following conservative management.

United European Gastroenterol J 2020 12 24;8(10):1163-1173. Epub 2020 Aug 24.

Amsterdam UMC, University of Amsterdam, Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands.

Background: Accurate information on the natural course of giant paraesophageal hernia is scarce, challenging therapeutic decisions whether or not to operate.

Objective: We aimed to investigate the long-term outcomes, including hernia-related deaths and complications (e.g. Read More

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December 2020

Intrathoracic sleeve gastrectomy migration with gastric volvulus treated with laparoscopic repair and conversion to gastric bypass.

J Surg Case Rep 2020 Aug 15;2020(8):rjaa234. Epub 2020 Aug 15.

Virginia Commonwealth University, Division of Bariatric Surgery, Richmond, VA, USA.

A 43 years old female with laparoscopic sleeve gastrectomy (SG) and an 'anterior' hiatal hernia repair 11 years ago, presented with 3 years history dysphagia and heartburn. Upper gastrointestinal barium showed an almost complete intrathoracic migration of the SG with a partial organoaxial volvulus. Upper endoscopy revealed a 10 cm hiatal hernia with grade B esophagitis. Read More

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Successful outcome in acute gastric volvulus in a low resource hospital setting in Bangladesh: A case report.

Int J Surg Case Rep 2020 15;72:443-447. Epub 2020 Jun 15.

Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh. Electronic address:

Introduction: Gastric volvulus is a rare medical emergency that can be fatal if not recognized early. Its rarity makes it quite challenging to diagnose but delaying in diagnosis and treatment can lead to fatal complications. Meticulous assessment and broadened differential diagnosis are thus crucial. Read More

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Midgut volvulus secondary to congenital malrotation in pregnancy.

BMJ Case Rep 2020 May 14;13(5). Epub 2020 May 14.

Department of General Surgery, The Northern Hospital, Epping, Victoria, Australia.

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Read More

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Transmesocolon internal hernia masking as simple sigmoid volvulus.

J Surg Case Rep 2020 Mar 9;2020(3):rjaa017. Epub 2020 Mar 9.

General Surgery Department, Joondalup Health Campus, Joondalup, Australia.

Transmesocolon internal hernias are very rare causes of bowel obstruction. Transmesenteric internal hernias normally associated with small bowel. It can be challenging to diagnose transmesocolon internal hernia hence we present a 93-year-old patient who was misdiagnosed with simple sigmoid volvulus on CT abdomen. Read More

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A Rare Case of Gastric Volvulus Post Laparoscopic Gastric Greater Curvature Plication.

Surg J (N Y) 2020 Jan 11;6(1):e24-e27. Epub 2020 Feb 11.

Senior Resident, Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.

Gastric volvulus is a rare entity. Its diagnosis remains tricky and challenging. In recent years, the incidence of gastric volvulus has shown a rise in postbariatric surgery patient. Read More

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January 2020

Volvulus with intestinal malrotation hiding a near-total intestinal aganglionosis: Case report.

J Neonatal Perinatal Med 2020 ;13(3):431-433

Department of Pediatric Surgery "A", Children Hospital "Bechir Hamza" of Tunis, Tunisia Université de Tunis El Manar, Tunis, Tunisia.

Total colonic aganglionosis occurring together with malrotation is a rare occurrence and may pose diagnostic and management dilemmas for the pediatric surgeon. We report the case of a new born, who was operated at the age of three days for malrotation with volvulus, treated by Ladd procedure. Postoperatively, we noticed persistent abdominal distension and emission of a small amount of meconium every 4 to 5 days. Read More

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January 2020

Laparoscopic gastric fundus tamponade: a novel adaptation of the Toupet fundoplication for large paraesophageal hernia repair.

Surg Endosc 2020 11 18;34(11):4803-4811. Epub 2019 Nov 18.

Section for Surgical Research, Department of Surgery, Medical University of Graz, 8036, Graz, Austria.

Background: Laparoscopic repair of large paraesophageal hiatal hernia with defects too large to close primarily or greater than 8 cm is technically challenging. The ideal repair remains unclear and is often debated. Utilizing the gastric fundus as an autologous patch to obliterate and tamponade large hiatal defects may offer a new solution. Read More

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November 2020

Gastric Dilatation Organoaxial Volvulus in a Dog.

J Am Anim Hosp Assoc 2020 Jan/Feb;56(1):42-47. Epub 2019 Nov 12.

From ACCESS Specialty Animal Hospitals, Culver City, California.

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November 2019

Herniation of the caecum and ascending colon through the foramen of Winslow: a case report and review.

M Sammut C Barben

Ann R Coll Surg Engl 2020 Feb 18;102(2):e39-e41. Epub 2019 Sep 18.

General Surgery Directorate, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.

Approximately 5% of intestinal obstruction cases are caused by internal herniation. Caecal herniation through the foramen of Winslow is considered a rare event. The management of caecal herniation remains challenging due to the lack of literature highlighting this pathology. Read More

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February 2020

Early Experience with Variant Two-Stage Approach in Surgical Management of Inflammatory Bowel Disease Colitis in the Pediatric Population.

J Laparoendosc Adv Surg Tech A 2019 Oct 9;29(10):1239-1243. Epub 2019 Aug 9.

Division of Pediatric Surgery, Department of Surgery, Cohen Children's Medical Center at Northwell Health, Queens, New York.

Multistaged surgical management of inflammatory bowel disease (IBD), culminating in ileal pouch-anal anastomosis (IPAA), can provide cure for refractory IBD symptoms while maintaining fecal continence. Surgical approaches to IPAA historically included a three-stage approach done by subtotal colectomy (STC) followed by IPAA with diversion. Recently, a variant two-stage approach without diversion at IPAA has become increasingly utilized, yet evidence of the efficacy of this approach is limited. Read More

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October 2019

Gallbladder volvulus in a patient with chronic lymphocytic leukemia treated with laparoscopic cholecystectomy.

Int J Crit Illn Inj Sci 2019 Apr-Jun;9(2):87-90

Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Gallbladder volvulus is a rare condition that most commonly occurs in elderly women and often mimics acute cholecystitis in its presentation. This condition is a surgical emergency requiring cholecystectomy as it can lead to gallbladder perforation and bilious peritonitis with high morbidity to the patient. An 85-year-old woman with chronic lymphocytic leukemia presented with acute-onset right upper-quadrant abdominal pain and associated nausea with emesis. Read More

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Small bowel volvulus versus adhesive small bowel obstruction: a diagnostic dilemma in a 19-year-old woman.

BMJ Case Rep 2019 Jun 26;12(6). Epub 2019 Jun 26.

Cairns Hospital, Cairns North, Queensland, Australia.

Small bowel volvulus (SBV) is often challenging to diagnose. Research suggests that the clinical presentation of this disease is often very similar to other more common causes of small bowel obstruction (SBO) such as intraabdominal adhesions and no single preoperative diagnostic study is sensitive or specific enough to identify this rare cause of mechanical SBO. This report describes a case of a 19-year-old woman who presented with irretractable vomiting and abdominal pain secondary to SBV. Read More

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Fetal Primary Small Bowel Volvulus Associated with Acute Gastric Dilatation Detected by Ultrasonography.

Kobe J Med Sci 2019 Jan 11;64(4):E157-E159. Epub 2019 Jan 11.

Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.

Fetal intestinal volvulus is a rare condition, and fetal diagnosis of this disease is still challenging, especially in primary cases not accompanied by other comorbidities, such as intestinal malformations. Herein, we report a case of fetal primary small bowel volvulus associated with acute gastric dilatation detected by ultrasonography. We speculate that the mechanism of acute gastric dilatation in our case was peristatic malfunction of the whole intestine caused by a strangulated ileus resulting from fetal intestinal volvulus. Read More

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January 2019

Meckel's enterolith : a rare cause of mechanical small bowel subobstruction.

Acta Gastroenterol Belg 2018 Oct-Dec;81(4):534-537

Department of Gastroenterology, AZ Klina, Brasschaat, Belgium.

Meckel's diverticulum is the most common congenital gastrointestinal malformation and may present with bleeding, obstruction and diverticulitis. Symptomatic Meckel's diverticulum is associated with age <50 years, male gender, diverticular length > 2 cm and ectopic mucosa. Formation of enteroliths is a rare complication of Meckel's diverticulum and the majority of stones will remain in the diverticulum. Read More

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A case report of a rare and challenging gangrenous splenic flexure volvulus in a pregnant patient.

Int J Surg Case Rep 2018 2;53:171-174. Epub 2018 Nov 2.

James Cook University, Cairns Base Hospital, QLD, Australia.

Introduction: Splenic flexure volvulus is a rare cause of intestinal obstruction and is uncommonly encountered in young patients from developed countries.

Presentation Of Case: This report details a challenging case of a gangrenous large bowel volvulus in a 25 year old woman 20 weeks pregnant, highlighting the diagnostic and operative challenges that this rare clinical situation presents. After urgent MRI confirming a splenic flexure volvulus, an emergency open left hemicolectomy and end colostomy was performed. Read More

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November 2018

PCR-coupled sequencing achieves specific diagnosis of onchocerciasis in a challenging clinical case, to underpin effective treatment and clinical management.

Infect Genet Evol 2018 12 17;66:192-194. Epub 2018 Sep 17.

Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia. Electronic address:

This study demonstrates the utility of a PCR-based DNA sequencing approach to make a specific diagnosis of onchocerciasis in a returned traveller. Although a clinical diagnosis was not possible, the surgical excision of a suprascapular nodule from this patient, combined with an histological examination of this nodule and PCR-based sequencing of DNA from a nematode from this lesion solved the case. The analysis of DNA sequence data confirmed the presence of Onchocerca volvulus infection, supporting an effective treatment-clinical management strategy for the patient. Read More

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December 2018

An audit of bilious vomiting in term neonates referred for pediatric surgical assessment: can we reduce unnecessary transfers?

J Pediatr Surg 2018 Nov 26;53(11):2123-2127. Epub 2018 Jul 26.

Department of Surgical Paediatrics, Royal Hospital for Children Glasgow, Glasgow, UK; University of Glasgow, Glasgow, UK. Electronic address:

Background: Between 20% and 50% neonates with bilious vomiting are diagnosed with surgical pathology. Distinguishing neonates requiring surgery remains challenging. Our aim was to conduct an audit of term neonates with bilious vomiting referred for assessment to identify characteristics of this cohort and management. Read More

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November 2018