Abdominal Twists and Turns: Part I, Gastrointestinal Tract Torsions With Pathologic Correlation

Timpone, Vincent M.; Lattin, Grant E.; Lewis, Rachel B.; Azuar, Keri; Tubay, Marc; Jesinger, Robert A.

doi:10.2214/ajr.10.7292

Cited by 16 publications

(10 citation statements)

References 20 publications

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“…More widely, connective tissue is strongly represented in various components of the GI apparatus , such as peritoneal ligaments, gut wall and splanchnic vessels. Peritoneal ligamentous laxity leading to hypermobility of the intra‐abdominal viscera is considered a predisposing factor to abdominal twists and torsions [Timpone et al, ], and could facilitate visceral prolapse or hernias under the additive effect of orthostatism and other factors increasing intra‐abdominal pressure (such as, pregnancy and chronic constipation). Accordingly, Curci et al [] found subtle alterations of the elastic fibers in the supporting ligaments of the gastro‐esophageal junction in patients with gastro‐esophageal reflux and hiatus hernia.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal and nutritional issues in joint hypermobility syndrome/ehlers–danlos syndrome, hypermobility type

Castori¹,

Morlino²,

Pascolini³

et al. 2015

American J of Med Genetics Pt C

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Gastrointestinal involvement is a well known complication of Ehlers-Danlos syndromes (EDSs), mainly in form of abdominal emergencies due to intestinal/abdominal vessels rupture in vascular EDS. In the last decade, a growing number of works investigated the relationship between a wide spectrum of chronic gastrointestinal complaints and various EDS forms, among which the hypermobility type (a.k.a. joint hypermobility syndrome; JHS/EDS-HT) was the most studied. The emerging findings depict a major role for gastrointestinal involvement in the health status and, consequently, management of JHS/EDS-HT patients. Nevertheless, fragmentation of knowledge limits its impact on practice within the boundaries of highly specialized clinics. In this paper, literature review on gastrointestinal manifestations in JHS/EDS-HT was carried out and identified papers categorized as (i) case-control/cohort studies associating (apparently non-syndromic) joint hypermobility and gastrointestinal involvement, (ii) case-control/cohort studies associating JHS/EDS-HT and gastrointestinal involvement, (iii) case reports/series on various gastrointestinal complications in (presumed) JHS/EDS-HT, and (iv) studies reporting gastrointestinal features in heterogeneous EDS patients' cohorts. Gastrointestinal manifestations of JHS/EDS-HT were organized and discussed in two categories, including structural anomalies (i.e., abdominal/diaphragmatic hernias, internal organ/pelvic prolapses, intestinal intussusceptions) and functional features (i.e., dysphagia, gastro-esophageal reflux, dyspepsia, recurrent abdominal pain, constipation/diarrhea), with emphasis on practice and future implications. In the second part of this paper, a summary of possible nutritional interventions in JHS/EDS-HT was presented. Supplementation strategies were borrowed from data available for general population with minor modifications in the light of recent discoveries in the pathogenesis of selected JHS/EDS-HT features.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal and nutritional issues in joint hypermobility syndrome/ehlers–danlos syndrome, hypermobility type

Castori¹,

Morlino²,

Pascolini³

et al. 2015

American J of Med Genetics Pt C

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“…Primary volvulus occurs in an otherwise normal abdomen; proposed risk factors include high fiber diets and altered gastrointestinal motility . Secondary volvulus occurs as a result of a preexisting factor or condition, including causes such as adhesions, congenital abnormalities (including malrotation), hernia, pregnancy, and previous surgery . In dogs, volvulus has been reported to affect the small and large intestine although both conditions are considered rare .…”

Section: Discussionmentioning

confidence: 99%

Imaging Diagnosis—use of Multiphasic Contrast‐enhanced Computed Tomography for Diagnosis of Mesenteric Volvulus in a Dog

Chow

Stent

Milne

2013

Vet Radiology Ultrasound

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A 4-year-old German shorthaired pointer presented with collapse and hematochezia. Radiographs showed gas and fluid-distended small intestines and loss of serosal detail. Ultrasound examination showed hypomotile, fluid-distended small intestines, and thrombosed jejunal veins. Multiphasic contrast-enhanced computed tomography was performed and showed a CT "whirl sign," an important but nonspecific sign of intestinal volvulus in human patients. At surgery, the majority of the small intestine was entangled in the volvulus and showed black discoloration. The patient was euthanized. Postmortem evaluation yielded a diagnosis of jejunoileal mesenteric volvulus secondary to a congenital omphalomesenteric duct remnant.

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“…13 In human medicine, torsion-related ischemia is also common and may involve any portion of the gastrointestinal tract from the stomach to the colon. 14 In contrast, urinary bladder torsion rarely occurs in veterinary and human medicine and is characterized by rotation of the organ, usually at the level of the trigone, with subsequent obstruction of urine outflow. In the only reported case in human medicine, urinary bladder torsion was associated with scrotal herniation of the bladder apex.…”

Section: Discussionmentioning

confidence: 99%

Urinary bladder torsion in a dog with an extraluminal tumor of the bladder apex

Bourbos

Liotta²,

Piola³

et al. 2021

Vet Record Case Reports

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A 12‐year‐old, spayed female, Lagotto Romagnolo dog is referred because of acute onset of stranguria, dysuria and abdominal discomfort after jumping from a height. Clinical examination reveals mild abdominal pain with enlargement of the urinary bladder and no hematological abnormalities. Computer tomographic examination identifies a large eccentric soft tissue mass with smooth margins, which contacts the serosal layer of the urinary bladder apex. The urinary bladder is pear‐shaped, displaced laterally, and has a longitudinal spiral pattern (whirlpool sign) in the bladder neck area. Celiotomy reveals a mass attached to the apex of the urinary bladder, which has a clockwise 180° torsion with no signs of necrosis. Partial cystectomy, after detorsion, is performed, and bladder incision is closed routinely. Histopathologic evaluation reveals a grade 1 leiomyosarcoma. Although urinary bladder torsion has been reported in five dogs, neoplastic lesions have not previously described as a cause of torsion and should be included in the differential diagnosis.

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Abdominal Twists and Turns: Part I, Gastrointestinal Tract Torsions With Pathologic Correlation

Cited by 16 publications

References 20 publications

Gastrointestinal and nutritional issues in joint hypermobility syndrome/ehlers–danlos syndrome, hypermobility type

Gastrointestinal and nutritional issues in joint hypermobility syndrome/ehlers–danlos syndrome, hypermobility type

Imaging Diagnosis—use of Multiphasic Contrast‐enhanced Computed Tomography for Diagnosis of Mesenteric Volvulus in a Dog

Urinary bladder torsion in a dog with an extraluminal tumor of the bladder apex

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