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Related Concept Videos

Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

763
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

933
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
933
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Sigmoid volvulus in children: a case report.

Fayza Haider1,2, Nabeel Al Asheeri3, Barrak Ayoub3

  • 1Pediatric Surgery Unit-Department of Surgery, Salmaniya Medical Complex, P.O. Box 12, Manama, Bahrain. drfayzahaider@gmail.com.

Journal of Medical Case Reports
|November 8, 2017
PubMed
Summary

Sigmoid volvulus, a rare cause of bowel obstruction in children, requires high suspicion for early diagnosis. Prompt treatment, including surgery if needed, leads to excellent outcomes in pediatric patients.

Keywords:
AdolescentsCase reportChildrenCoffee bean signDecompressionEndoscopyPrimary anastomosisSigmoid volvulusSigmoidectomy

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Sigmoid volvulus is a common cause of large bowel obstruction in specific geographic regions but is rare in children.
  • It is often overlooked in pediatric patients, necessitating a high index of suspicion for timely diagnosis.

Observation:

  • A 13-year-old girl presented with symptoms of intestinal obstruction.
  • Radiography revealed the characteristic 'omega' or 'coffee bean' sign of sigmoid volvulus.
  • Initial non-operative decompression via rectal tube and endoscopy was successful, but recurrence led to surgical sigmoidectomy.

Findings:

  • Sigmoid volvulus is an uncommon but critical diagnosis in pediatric intestinal obstruction.
  • Delayed diagnosis and treatment of pediatric sigmoid volvulus can significantly increase morbidity and mortality.
  • Early detection and prompt intervention are crucial for a favorable prognosis.

Implications:

  • Pediatric surgeons must consider sigmoid volvulus in the differential diagnosis of intestinal obstruction in children.
  • Prompt management, whether non-operative or surgical, is essential for preventing severe complications.
  • This case highlights the importance of vigilance and timely intervention in pediatric cases of sigmoid volvulus.