Volvulus of the small intestine – Diagnosis and surgical treatment
- Author:
Truong Cong Tru
- Publication Type:Journal Article
- Keywords:
Volvulus
- MeSH:
Intestinal Volvulus;
Intestine, Small;
Diagnosis;
Therapeutics;
Surgery
- From:Journal Ho Chi Minh Medical
2005;9(3):157-161
- CountryViet Nam
- Language:Vietnamese
-
Abstract:
There were 1,360 cases of intestinal obstruction at Cho Ray Hospital in 5 years (from January 1st 1999 to December 30th 2003). Of these, there were 100 cases with small intestine volvulus (7.35%). Diagnosis was mainly based on clinical symptoms and signs. Constant, noncramping abdominal pain with necrosis of the small intestine was most frequently (73%, p < 0.05). Rigidity was found in 53% patients and was correspondent with bowel necrosis (p< 0.05). Abdominal distention was found in 58%, peristaltic waves in 21%, Von Valh’s sign in 17% and shock in 32%. Upright plain radiographs showed air-fluid levels in 63.3% cases. The image of pseudotumor, single or multiple concentrated dilated loops was seen in 11.5%. Thick inter-space between the intestinal loops or blur pelvic area in the plain radiograph was found in 42.5% and the plain radiograph showed unspecific image in 26.4%. Patients with history of abdominal operation accounted for 85%. Causes of small intestine volvulus: adhesion band (post-operative) 80%, small intestinal tumor 4% and 16% of unknown origin. About treatment: de-adhesion and detorsion of the volvulus accounted for 60% of cases; other 40% required excision of the small intestine. Indication of the treatment methods was correspondent to injury of the intestine evaluated intra-operatively (p<0.05). No mortality was recognized in this study
