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Related Concept Videos

Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

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Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
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Appendicitis01:19

Appendicitis

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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
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Multimodality Diagnosis of Mesenteric Ischemia
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Midgut volvulus induced extensive bowel infarction.

Tai-Yu Huang1, Hsing Chang1, Kun-Chuan Chen1

  • 1Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, Hualien, 970 Taiwan.

The Indian Journal of Surgery
|June 4, 2014
PubMed
Summary

Midgut volvulus, a rare complication of malrotation or acquired conditions, can cause bowel ischemia. Early diagnosis via CT imaging, like the whirl sign, and prompt surgery are crucial to prevent extensive bowel necrosis.

Keywords:
Bowel infarctionIschemic bowel diseaseMidgut volvulusWhirl sign

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Area of Science:

  • Gastroenterology
  • Surgical Emergency
  • Abdominal Imaging

Background:

  • Midgut volvulus is a rare but life-threatening complication, often stemming from congenital midgut malrotation.
  • It can also arise from acquired conditions including postoperative adhesions, tumors, and mesenteric cysts.
  • This condition leads to bowel ischemia due to superior mesenteric artery torsion, necessitating urgent intervention.

Purpose of the Study:

  • To report a case of midgut volvulus presenting with characteristic computed tomography (CT) findings.
  • To highlight the importance of early diagnosis and surgical intervention in preventing extensive bowel necrosis.

Main Methods:

  • Case report of a patient with midgut volvulus.
  • Utilized computed tomography (CT) for diagnosis, identifying key features such as the whirl sign and transposition of the superior mesenteric artery and vein.
  • Performed early surgical intervention.

Main Results:

  • The CT scan revealed the characteristic whirl sign, indicating torsion of the superior mesenteric artery.
  • Transposition of the superior mesenteric artery and vein was observed.
  • Early surgical intervention successfully prevented extensive bowel resection and necrosis.

Conclusions:

  • Midgut volvulus, even when acquired, is a surgical emergency requiring prompt diagnosis.
  • Characteristic CT findings, including the whirl sign, are vital for early identification.
  • Timely surgical management is critical to avoid catastrophic outcomes such as extensive bowel resection.