Double trouble

Concurrent sigmoid volvulus and gastric volvulus in Alzheimer's disease

Ngo Choon Woon, Nik Ritza Kosai Nik Mahmood, Razman Jarmin, Mohammed Aznan Shuhaili, Mustafa Mohd Taher, Reynu Rajan

Research output: Contribution to journalArticle

Abstract

Background: Volvulus is the rotation of a hollow viscus either on its mesentery or upwards against its own body. Multiple gastrointestinal volvuli occurring in a single individual is extremely rare. Several reports have suggested sequential dilatation of the proximal sigmoid as the triggering factor for the development of the gastric volvulus. This is only the 4th case of concurrent sigmoid and gastric volvulus to be reported in the world and the first in Asia, making it a rare and unique learning opportunity for surgeons of all ages with varying levels of experience. Case Report: We discuss an acute presentation of concurrent sigmoid and gastric volvulus in an elderly individual with underlying Alzheimer's disease. Despite initial endoscopic treatment, he eventually succumbed as a result of septic shock with multi-organ failure secondary to bowel ischemia. Discussion and Conclusion: The increased morbidity and mortality risk associated with the dual pathology warrants high index of suspicion and prompt management. Clinical symptoms and radiological imaging are often sufficient to reach a diagnosis. Decision to treat the patient conservatively, endoscopically or surgically would depend on the manner of presentation. The relative vascularity of all affected organs should be taken into consideration when prioritizing the order of organs to undergo de-torsion and decompression.

Original languageEnglish
Article number8
JournalOnline Journal of Health and Allied Sciences
Volume16
Issue number3
Publication statusPublished - 1 Jan 2017

Fingerprint

Stomach Volvulus
Intestinal Volvulus
Sigmoid Colon
Alzheimer Disease
Mesentery
Viscera
Septic Shock
Decompression
Dilatation
Ischemia
Learning
Pathology
Morbidity
Mortality
Therapeutics

Keywords

  • Colectomy
  • Endoscopy
  • Gastrectomy
  • Gastric outlet obstruction
  • Intestinal obstruction
  • Volvulus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Double trouble : Concurrent sigmoid volvulus and gastric volvulus in Alzheimer's disease. / Woon, Ngo Choon; Nik Mahmood, Nik Ritza Kosai; Jarmin, Razman; Shuhaili, Mohammed Aznan; Taher, Mustafa Mohd; Rajan, Reynu.

In: Online Journal of Health and Allied Sciences, Vol. 16, No. 3, 8, 01.01.2017.

Research output: Contribution to journalArticle

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