ABSTRACT
A case of acute gastric volvulus has been presented. Although this disorder can occur in a chronic intermittent fashion, the potentially catastrophic acute form should be diagnosed early and surgically corrected. Careful attention to presenting signs and a high index of suspicion lead to prompt recognition and treatment.
Subject(s)
Stomach Volvulus , Acute Disease , Child, Preschool , Humans , Male , Stomach Volvulus/diagnosis , Stomach Volvulus/pathology , Stomach Volvulus/surgeryABSTRACT
Gastroduodenal intussusception is an extremely uncommon condition usually caused by the prolapse of a benign gastric tumor into the duodenum with subsequent invagination of a portion of the stomach wall. A rare case of this condition associated with a gastric lipoma is presented. Clinical manifestations may mimic many other disease entities and are nonspecific. Diagnosis, however, can often be made preoperatively with noninvasive tests, which are usually associated with more specific signs. Treatment involves reduction of the intussusception and surgical excision of the lead point, either endoscopically or through a formal laparotomy.
Subject(s)
Intussusception/diagnosis , Lipoma/complications , Stomach Diseases/diagnosis , Stomach Neoplasms/complications , Aged , Barium Sulfate , Biopsy , Female , Gastroscopy , Humans , Intussusception/epidemiology , Intussusception/etiology , Lipoma/pathology , Lipoma/surgery , Risk Factors , Stomach Diseases/epidemiology , Stomach Diseases/etiology , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , UltrasonographyABSTRACT
A 7-year experience involving 12 cases of massive, unrelenting lower gastrointestinal hemorrhage is presented. In these patients, the bleeding could not be localized by multiple diagnostic modalities and was managed by blind subtotal colectomy. While the procedure was efficacious in arresting bleeding in all cases, a resultant mortality of four cases (33%) ensued. Morbidity among the survivors was significant. Only three patients (25%) survived without complications, which enabled an early discharge from the hospital. Diverticulosis was the most common cause (83%) of uncontrollable and preoperatively undiagnosed bleeding in this group of patients. These 12 cases of blind subtotal colectomy for massive lower gastrointestinal bleeding represent one of the larger series in the literature. These data are consistent with more recent reports that indicate that subtotal colectomy for lower gastrointestinal bleeding is an effective but a formidable procedure. This is contrary to the earlier published results.
