Comment on sigmoid volvulus treated with colonoscopic decompression followed by snare‐assisted side‐hole tube placement

2019 ◽  
Vol 22 (1) ◽  
pp. 103-104 ◽  
Author(s):  
S. S. Atamanalp
Keyword(s):  
Sigmoid Volvulus ◽  
Tube Placement ◽  
Side Hole ◽  
Colonoscopic Decompression

scholarly journals Radiation exposure dose of fluoroscopy-guided gastrointestinal procedures: A single-center retrospective study

2020 ◽  
Vol 08 (12) ◽  
pp. E1872-E1877
Author(s):  
Shiro Hayashi ◽  
Tsutomu Nishida ◽  
Shinji Kuriki ◽  
Li-sa Chang ◽  
Kazuki Aochi ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Balloon Dilatation ◽  
Exposure Dose ◽  
Sigmoid Volvulus ◽  
Tube Placement ◽  
Injection Sclerotherapy ◽  
Single Center ◽  
Endoscopic Injection ◽  
Dose Area Product ◽  
Esophageal Balloon

Abstract Background and study aims Fluoroscopy-guided gastrointestinal procedures (FGPs) are increasingly common. However, the radiation exposure (RE) to patients undergoing FGPs is still unclear. We examined the actual RE of FGPs. Patients and methods This retrospective, single-center cohort study included consecutive FGPs, including endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasound (EUS), enteral stenting, balloon-assisted enteroscopy, tube placement, endoscopic injection sclerotherapy (EIS), esophageal balloon dilatation and repositioning for sigmoid volvulus, from September 2012 to June 2019. We measured the air kerma (AK, mGy), dose area product (DAP, Gycm2), and fluoroscopy time (FT, min) for each procedure. Results In total, 3831 patients were enrolled. Overall, 2778 ERCPs were performed. The median AK, DAP, and FT were as follows: ERCP: 109 mGy, 13.3 Gycm2 and 10.0 min; self-expandable enteral stenting (SEMS): 62 mGy, 12.4 Gycm2 and 10.4 min; tube placement: 40 mGy, 13.8 Gycm2 and 11.1 min; balloon-assisted enteroscopy: 43 mGy, 22.4 Gycm2 and 18.2 min; EUS cyst drainage (EUS-CD): 96 mGy, 18.3 Gycm2 and 10.4 min; EIS: 36 mGy, 8.1 Gycm2 and 4.4 min; esophageal balloon dilatation: 9 mGy, 2.2 Gycm2 and 1.8 min; and repositioning for sigmoid volvulus: 7 mGy, 4.7 Gycm2 and 1.6 min. Conclusion This large series reporting actual RE doses of various FGPs could serve as a reference for future prospective studies.

scholarly journals Recurrent Sigmoid Volvulus – Early Resection may Obviate Later Emergency Surgery and Reduce Morbidity and Mortality

2009 ◽  
Vol 91 (3) ◽  
pp. 205-209 ◽  
Author(s):  
JO Larkin ◽  
TB Thekiso ◽  
R Waldron ◽  
K Barry ◽  
PW Eustace
Keyword(s):  
Emergency Surgery ◽  
Hospital Admissions ◽  
Elective Surgery ◽  
Postoperative Mortality ◽  
Operative Management ◽  
Sigmoid Volvulus ◽  
High Rate ◽  
Colonoscopic Decompression ◽  
Non Operative Management ◽  
Overall Mortality

INTRODUCTION Acute sigmoid volvulus is a well recognised cause of acute large bowel obstruction. PATIENTS AND METHODS We reviewed our unit's experience with non-operative and operative management of this condition. A total of 27 patients were treated for acute sigmoid volvulus between 1996 and 2006. In total, there were 62 separate hospital admissions. RESULTS Eleven patients were managed with colonoscopic decompression alone. The overall mortality rate for non-operative management was 36.4% (4 of 11 patients). Fifteen patients had operative management (five semi-elective following decompression, 10 emergency). There was no mortality in the semi-elective cohort and one in the emergency surgery group. The overall mortality for surgery was 6% (1 of 15). Five of the seven patients managed with colonoscopic decompression alone who survived were subsequently re-admitted with sigmoid volvulus (a 71.4% recurrence rate). The six deaths in our overall series each occurred in patients with established gangrene of the bowel. With early surgical intervention before the onset of gangrene, however, good outcomes may be achieved, even in patients apparently unsuitable for elective surgery. Eight of the 15 operatively managed patients were considered to be ASA (American Society of Anesthesiologists) grade 4. There was no postoperative mortality in this group. CONCLUSIONS Given the high rate of recurrence of sigmoid volvulus after initial successful non-operative management and the attendant risks of mortality from gangrenous bowel developing with a subsequent volvulus, it is our contention that all patients should be considered for definitive surgery after initial colonoscopic decompression, irrespective of the ASA score.

Volvulus of the Transverse Colon

2021 ◽  
pp. 000313482110415
Author(s):  
Sergio Huerta ◽  
Maryanne L. Pickett ◽  
Ann M. Mottershaw ◽  
Pramod Gupta ◽  
Thai Pham
Keyword(s):  
World Literature ◽  
Present Report ◽  
The United States ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
Cecal Volvulus ◽  
Colonic Volvulus ◽  
Cardiopulmonary Complications ◽  
Common Operation ◽  
Colonoscopic Decompression

Background In the United States, the third leading cause of a large bowel obstruction (LBO) is colonic volvulus with torsion occurring most commonly in the sigmoid and the cecum. Transverse colonic volvulus (TCV) is exceedingly rare and specific involvement of the splenic flexure (SFV) is even less common. The present analysis was undertaken to interrogate current trends in presentation, management, and outcomes of TCV. Methods In the present report, the world literature was reviewed for the past 90 years (1932 to 2021). We conducted a systematic review to identify all cases of TCV following the PRISMA guidelines. Results We identified 317 cases of TCV. This included SFV (n = 75), TCV in pediatric patients (n = 63), TCV in pregnant patients (n = 8), and TCV associated with other pathology such as Chilaiditi’s syndrome (n = 11). Compared to sigmoid and cecal volvulus, TCV was rare (.94%). It affected slightly more women (54%) than men, commonly in their third decade of life (37.7 ± 23.8). The clinical presentation and diagnostic imaging were consistent with LBO. Compared to sigmoid volvulus, there was a limited role for conservative management and colonoscopic decompression was less effective. The most common operation was segmental resection (25%). Mortality was (20%) commonly because of cardiopulmonary complications and affected more women (63%). The average age of this cohort was 55.7±24.6 years old. Discussion Our review showed that TCV is an uncommon surgical entity. The diagnosis is likely to be made at laparotomy. Prompt recognition is paramount in preventing ischemia necrosis and perforation. Compared to sigmoid and cecal volvulus, the mortality for TCV remains high.

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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