Volvulus Health Dictionary

(Syn. “river blindness”) A. disease caused by the parasitic filarial nematode Onchocerca volvulus. (See also filariasis).... onchocerciasis

The term used to describe several clinical entities caused by one or other of the nematode ?lariae; these include Wuchereria bancrofti/Brugia malayi, Onchocerca volvulus, Loa loa, Dracunculus medinensis (DRACONTIASIS or guinea-worm disease), Mansonella perstans, etc. These organisms have widely di?ering geographical distributions. Whereas lymphatic ?lariasis is present throughout much of the tropics and subtropics, ONCHOCERCIASIS (river-blindness) is largely con?ned to west and central Africa and southern America. Loaiasis is an infection of west and central Africa, and dracontiasis involves west and central Africa and western India only.

Clinically, the lymphatic ?lariases characteristically cause ELEPHANTIASIS (lymphoedema); onchocerciasis gives rise to ophthalmic complications (river-blindness), rashes and subcutaneous nodules; loaiasis causes subcutaneous ‘Calabar swellings’ and subconjunctival involvement; and dracontiasis predisposes to secondary bacterial infections (usually involving the lower limbs). Diagnosis is by ?nding the relevant ?larial nematode, either in blood (day and night ?lms should be examined), or in one or other of the body ?uids. An EOSINOPHILIA is often present in peripheral blood. Serological diagnosis is also of value. In onchocerciasis, skin-snips and the Mazotti reaction are valuable adjuncts to diagnosis.

The mainstay of chemotherapy consists of diethylcarbamazine (aimed predominantly at the larval stage of the parasite). However, ivermectin (not available in the UK) is e?ective in onchocerciasis, and metronidazole or one of the benzimidazole compounds have limited value in dracontiasis. Suramin has been used to kill adult ?larial worms. Prevention consists of eradication of the relevant insect vector.... filariasis

The constriction of a passage or tube in the body that blocks the blood ?ow and disturbs the working of the affected organ. It is usually caused by compression or twisting. Strangulation customarily occurs when part of the INTESTINE herniates either inside the abdomen or outside as in an inguinal HERNIA. If a section of the intestine twists, this may strangulate and is known as a VOLVULUS.

Strangulation of a person’s neck, either with a ligature or with the hands, obstructs the jugular veins in the neck, preventing the normal out?ow of blood from the brain and head. The TRACHEA is also compressed, cutting o? the supply of air to the lungs. The combination of these effects leads to HYPOXIA and damage to the brain. If not quickly relieved, unconsciousness and death follow. Strangulation may be deliberate or accidental – the latter being a particular hazard for children, for example, when playing with a rope. Removal of the constriction, arti?cial respiration, and medical attention are urgently necessary.... strangulation

Discomfort in the abdomen. Mild abdominal pain is common and is often due to excessive alcohol

intake, eating unwisely, or an attack of diarrhoea. Pain in the lower abdomen is common during menstruation but is occasionally due to a gynaecological disorder such as endometriosis. Cystitis is a common cause of pain or discomfort in the abdomen. Bladder distension as a result of urinary obstruction may also cause abdominal pain.

Abdominal colic is pain that occurs every few minutes as one of the internal organs goes into muscular spasm in an attempt to overcome an obstruction such as a stone or an area of inflammation. The attacks of colic may become more severe and may be associated with vomiting (see abdomen, acute).

Peptic ulcer often produces recurrent gnawing pain. Other possible causes of abdominal pain are infection, such as pyelonephritis, and ischaemia (lack of blood supply), as occurs when a volvulus (twisting of the intestine) obstructs blood vessels. Tumours affecting an abdominal organ can cause pain. Abdominal pain can also result from anxiety.

For mild pain, a wrapped hot-water bottle is often effective. Pain due to peptic ulcer can be temporarily relieved by food or by taking antacid drugs. Abdominal pain that is not relieved by vomiting, persists for more than 6 hours, or is associated with sweating or fainting requires urgent medical attention. Urgent attention is also necessary if pain is accompanied by persistent vomiting, vomiting of blood, or passing of bloodstained or black faeces. Unexplained weight loss or changes in bowel habits should always be investigated.

Investigation of abdominal pain may include the use of imaging tests such as ultrasound scanning, and endoscopic examination in the form of gastroscopy, colonoscopy, or laparoscopy.... abdominal pain

The stomach may be affected by various disorders, including gastrointestinal infections, peptic ulcers, gastritis, pyloric stenosis, volvulus, polyps, and stomach cancer.... stomach, disorders of the

n. the passage of fresh red blood through the rectum. Haematochesia occurs in patients with haemorrhoids, colorectal carcinoma, colitis, diverticulitis, angiodysplasia, and volvulus. Haematochesia also occurs as a result of severe haemorrhage in the upper gastrointestinal tract.... haematochesia

n. the death of part or the whole of an organ that occurs when the artery carrying its blood supply is obstructed by a blood clot (thrombus) or an *embolus. For example, *myocardial infarction, affecting the muscle of the heart, follows coronary thrombosis. A small localized area of dead tissue produced as a result of an inadequate blood supply is known as an infarct. Infarcts also arise when venous outflow from an organ or tissue is obstructed, as occurs when the ovary or testis twist on their vascular pedicles (stalks), or when the sigmoid colon twists in *volvulus.... infarction

(sigmoidectomy) surgical removal of the sigmoid colon using either an open approach (see laparotomy) or *laparoscopy. It is performed for tumours, severe *diverticular disease, or for an abnormally long sigmoid colon that has become twisted (see volvulus).... sigmoid colectomy

The intestine is subject to various structural abnormalities and to the effects of many infective organisms and parasites; it may also be affected by tumours and other disorders.

Structural abnormalities may be present from birth (congenital) or may develop later. They cause blockage of the intestine (see intestine, blockage of) and include atresia, stenosis, and volvulus. In newborns, meconium (fetal intestinal contents) may block the intestine.

Generalized inflammation of the intestine may result from viral or bacterial infections or from noninfectious causes, as in ulcerative colitis and Crohn’s disease. Gastroenteritis is the term commonly applied to inflammation of the stomach and intestines. Infection encompasses food poisoning, traveller’s diarrhoea, typhoid fever, cholera, amoebiasis, and giardiasis. Intestinal worm infestations include roundworms and tapeworms. Sometimes inflammation is localized, such as in appendicitis and diverticular disease.

Tumours of the small intestine are rare, but noncancerous growths, lymphomas, and carcinoid tumours (causing carcinoid syndrome) occur. Tumours of the large intestine are common (see colon, cancer of; rectum, cancer of). Some forms of familial polyposis may progress to cancer. Impaired blood supply (ischaemia) to the intestine may occur as a result of partial or complete obstruction of the arteries in the abdominal wall (from diseases such as atherosclerosis) or from the blood vessels being compressed or trapped, as in intussusception or hernias. Loss of blood supply may cause gangrene.

Other disorders that affect the intestine include peptic ulcers, diverticulosis, malabsorption, coeliac disease, and irritable bowel syndrome.... intestine, disorders of

A partial or complete blockage of the small or large intestine. Causes include a strangulated hernia; stenosis (narrowing) of the intestine, often due to cancer in the intestine; intestinal atresia; adhesions; volvulus; and intussusception. Intestinal obstruction also occurs in diseases that affect the intestinal wall, such as Crohn’s disease. In less common cases, internal blockage of the intestinal canal is caused by impacted food, faecal impaction, gallstones, or an object that has been accidentally swallowed.

A blockage in the small intestine usually causes intermittent cramp-like pain in the centre of the abdomen with increasingly frequent bouts of vomiting and failure to pass wind or faeces. An obstruction in the large intestine causes pain, distension of the abdomen, and failure to pass wind or faeces.

Treatments involve emptying the stomach via a nasogastric tube and replacing lost fluids through an intravenous drip In some cases, this will be sufficient to correct the problem. However, in many cases, surgery to deal with the cause of the blockage is necessary.... intestine, obstruction of

A common problem, present at birth, in which a small, hollow, wide-mouthed sac protrudes from the ileum. Symptoms only occur when the diverticulum becomes infected, obstructed, or ulcerated. The most common symptom is painless bleeding, which may be sudden and severe, making immediate blood transfusion necessary. Inflammation may cause symptoms very similar to those of acute appendicitis. Meckel’s diverticulum occasionally causes intussusception or volvulus of the small intestine. Diagnosis of Meckel’s diverticulum may be made by using technetium radionuclide scanning. If complications occur, they are treated by surgical removal of the diverticulum.... meckel’s diverticulum

n. intestinal obstruction, usually obstruction of the small intestine (ileum). Clinical symptoms include abdominal pain and distension, vomiting, and absolute constipation. Paralytic or adynamic ileus is functional obstruction of the ileum due to loss of intestinal movement (peristalsis), which may be caused by abdominal surgery (see laparotomy); spinal injuries; electrolyte abnormalities, particularly of potassium (hypokalaemia); peritonitis; or ischaemia. Treatment consists of intravenous administration of fluid and removal of excess stomach secretions by nasogastric tube until peristalsis returns (the ‘drip and suck’ approach). If possible, the underlying condition is treated. Mechanical ileus may be caused by gallstones entering the bowel through a fistula or widened bile duct (gallstone ileus); tumour; *intussusception; intestinal *volvulus; foreign bodies; thickened *meconium in newborn babies (meconium ileus); or parasitic infestation, for example with the threadworm Enterobius vermicularis (verminous ileus).... ileus