Year: 1967
Type: article
Abstract: MICALJOURNALfood (Kerr and Kirkaldy-Willis, 1946 ;McWatters, 1945).Rose (1955), discussing the aetiology, mentioned hypermotility and bowel distension as exciting causes.In secondary volvulus there is usually an abnormal congenital or acquired fixation of the intestine.In this case the past history is consistent with attacks of subacute volvulus recurring over seven years.Though no anatomical abnormality was obvious in the mesentery, a volvulus through 720 degrees suggests undue mobility and length of mesentery.This could have been the result of previous subacute attacks of volvulus or it could have predisposed to them.Bulky diets are said to cause an increase in length of bowel and mesentery as well as hypermotility (Dickson, 1950).There was no evidence of unusual dietary habits in this patient.The right inguinal hernia might have anchored a loop of small intestine and produced a secondary volvulus.However, this hernia was said to be easily reducible up to the final attack of strangulation and to have been present for only two years.If it was responsible its repair should have cured the tendency for the bowel to undergo volvulus.The final attack of volvulus appeared to start only after the inguinal hernia had been repaired and the bowel resected.It is possible, though unlikely, that the anastomosis acted like the occasionally reported antimesenteric tumour by partly anchor- ing the bowel and predisposing to volvulus (Aird, 1957).Lulenski (1961) reported cases where volvulus was super- imposed on small-bowel obstruction.In this case the anastomosis appeared widely patent without any evidence that it could have caused mechanical obstruction.After any abdo- minal operation, especially with intestinal resection, there occur transient ileus, gaseous and fluid distension of bowel, and later
Source: BMJ
Author: D. Llewellyn-Jones
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2001024199