Volvulus epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
The epidemiological data found on volvulus is scarce, however, acute mechanical small bowel obstruction is a common surgical emergency. It is estimated that over 300,000 laparotomies are performed per year in the United States for adhesion-related obstructions such as volvulus . | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
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*Sigmoid volvulus has the highest incidence accounting for 75 - 80% of volvulus cases | *Sigmoid volvulus has the highest incidence accounting for 75 - 80% of volvulus cases | ||
*Cecal volvulus has the second highest incidence accounting for 20 - 25% of volvulus cases. | *Cecal volvulus has the second highest incidence accounting for 20 - 25% of volvulus cases. | ||
*In other studies, the incidence of cecal volvulus | *The incidence of cecal volvulus increases by 5.53 percent per year, whereas the incidence of sigmoid volvulus remains stable. | ||
* | *In other studies, the incidence of cecal volvulus ranges from 2.8 to 7.1 per million people per year. | ||
*The incidence of gastric volvulus is rare. | |||
===Prevalence=== | ===Prevalence=== | ||
In an epidemiologic study, 63,749 cases of colonic obstruction were admitted in the United States from 2002 to 2010 [14]. | In an epidemiologic study, 63,749 cases of colonic obstruction were admitted in the United States from 2002 to 2010 [14]. . | ||
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide. | *In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide. | ||
*The prevalence of [disease/malignancy] is estimated to be [number] cases annually. | *The prevalence of [disease/malignancy] is estimated to be [number] cases annually. | ||
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===Developing Countries=== | ===Developing Countries=== | ||
Revision as of 18:17, 27 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: ; Hadeel Maksoud M.D.[2]
Overview
The epidemiological data found on volvulus is scarce, however, acute mechanical small bowel obstruction is a common surgical emergency. It is estimated that over 300,000 laparotomies are performed per year in the United States for adhesion-related obstructions such as volvulus .
Epidemiology and Demographics
Incidence
- The incidence of volvulus is approximately 2 per 100,000 individuals worldwide.
- Sigmoid volvulus has the highest incidence accounting for 75 - 80% of volvulus cases
- Cecal volvulus has the second highest incidence accounting for 20 - 25% of volvulus cases.
- The incidence of cecal volvulus increases by 5.53 percent per year, whereas the incidence of sigmoid volvulus remains stable.
- In other studies, the incidence of cecal volvulus ranges from 2.8 to 7.1 per million people per year.
- The incidence of gastric volvulus is rare.
Prevalence
In an epidemiologic study, 63,749 cases of colonic obstruction were admitted in the United States from 2002 to 2010 [14]. .
- In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
- The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
Case-fatality rate/Mortality rate
- In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
- The case-fatality rate/mortality rate of [disease name] is approximately [number range].
Age
Sigmoid volvulus usually occurs in older adults with a mean age of 70 years at presentation [5]. Sigmoid volvulus has been reported in younger patients and in children in association with abnormal colonic motility [15-20]. (See 'Colonic dysmotility' below.) astric volvulus is rare. The incidence peaks after the fifth decade with adults constituting 80 to 90 percent of cases
- Patients of all age groups may develop [disease name].
- The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
- [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
- [Chronic disease name] is usually first diagnosed among [age group].
- [Acute disease name] commonly affects [age group].
Race
A longer sigmoid colon and mesentery in males (especially in black Africans) could be the reason for an increased likelihood of volvulus [22,23].
- There is no racial predilection to [disease name].
- [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
Gender
Gastric Volvulus
G[5]. No association with sex or race has been reported.
cecal volvulus was more prevalent in younger females. Although some series have reported a predominance in men, others have found no difference in incidence by gender [4,13,21].
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
Region
- The majority of [disease name] cases are reported in [geographical region].
The incidence of sigmoid volvulus is not well established (picture 1). In the United States, sigmoid volvulus is a relatively uncommon cause of intestinal obstruction, representing fewer than 10 percent of cases in most series [1,5]. In contrast, sigmoid volvulus is the underlying etiology in 50 to 80 percent of patients with intestinal obstruction in other parts of the world [6-10]. (See "Chagas disease: Pathology and pathogenesis".)
- [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
Developed Countries
Developing Countries
Neonatal and Infantile volvulus
Rotational anomalies occur as a result of an arrest of normal rotation of the embryonic gut. Because rotational anomalies may remain asymptomatic throughout a person’s life span, the true incidence is not known. Nonrotation, a type of malrotation is an incidental finding on approximately 2 out of 1000 upper gastrointestinal contrast studies [1]. Symptomatic malrotation in neonates occurs with a frequency of about 1 in 6000 live births.
Traditionally, intestinal malrotation has been considered primarily a disease of infancy with infrequent occurrence beyond the first year of life [2,3]. However, analysis of 2744 cases of intestinal rotation in children up to 17 years of age obtained from a national hospital discharge database found the following [2]:
●Presentation by one month of age: 30 percent
●Presentation before one year of age: 58 percent
●Presentation before five years of age: 75 percent
Similarly, in a series of 170 patients of all ages with symptomatic intestinal malrotation managed at a single institution, age distribution at time of presentation was as follows [3]:
●Infants under one year of age: 31 percent
●Children 1 to 18 years of age: 21 percent
●Adults over 18 years of age: 48 percent
Thus, the prevalence of malrotation in children over one year of age and adults appears to be higher than previously thought.
Associated congenital defects — Up to 62 percent of children who have intestinal malrotation have an associated anomaly (table 1) [4-7].
Based upon a systematic review of small, single-institution studies, the following conditions have demonstrated a strong association with intestinal malrotation [8]:
●Congenital diaphragmatic hernia – Up to 100 percent
●Congenital heart disease, especially heterotaxy syndrome – 40 to 90 percent (see 'Screening' below)
●Omphalocele – 31 to 45 percent
Intestinal malrotation is also associated with:
●Gastroschisis (see "Gastroschisis", section on 'Associated anomalies and findings')
●Prune belly syndrome (see "Prune-belly syndrome", section on 'Abdominal wall and gastrointestinal tract')
●Certain types of intestinal atresias [9] (see "Intestinal atresia")
●Esophageal atresia (solitary and with tracheoesophageal fistula) [10]
●Biliary atresia in patients with laterality malformations (see "Biliary atresia", section on 'Types of biliary atresia')
●Meckel diverticulum [11]
●Complex anorectal malformations or anorectal malformations with 2 or more anomalies of the VACTERL (vertebral, anal, cardiac, tracheoesophageal, renal, limb) complex [12,13]
●Cornelia de Lange syndrome [14]