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Surgical abdominal emergencies among patients with cerebral palsy (CP) are infrequently reported. The most commonly reported reason for urgent and emergent abdominal surgery among patients with CP is intestinal volvulus. Intestinal volvulus leads to obstruction and vascular compromise, potentially resulting in life-threatening ischemia and necrosis. Volvulus typically presents with abdominal pain and decreased bowel function. When patients are nonverbal and have baseline bowel dysfunction, symptoms of volvulus can be difficult to diagnose. Here, we present a case of an adult female patient with CP who presented with ischemic colitis with perforation and underwent emergency total colectomy and end-ileostomy. Her postoperative course was complicated by two episodes of intestinal volvulus that occurred one and three months after the initial operation. At the second presentation, she had global bowel ischemia due to the volvulus, which led to her death. We have reviewed and summarized the current literature regarding abdominal emergencies among patients with CP. [ABSTRACT FROM AUTHOR]

Background: Ulcerative colitis, total colectomy and tofacitinib have all been associated with increased risk of venous thromboembolism., Objective: To determine if preoperative tofacitinib exposure increases venous thromboembolism or other postoperative complications among patients with ulcerative colitis undergoing subtotal colectomy, total colectomy or total proctocolectomy., Design: Retrospective, case-control study at a single institution., Settings: A tertiary referral center., Patients: Adult patients with ulcerative colitis undergoing subtotal colectomy, total colectomy or total proctocolectomy after 2018 who were taking tofacitinib within 30 days of surgery (n = 56) were compared to age and sex-matched patients with ulcerative colitis undergoing the same surgeries but who were not exposed to tofacitinib (n = 56)., Main Outcome Measure: The primary outcome was differences in the incidence of venous thromboembolism within 90 days of surgery based on tofacitinib exposure. Secondary outcomes were 90-day postoperative complications., Results: Groups were well matched for age (non-tofacitinib: mean 35.2 years [SD 12.0], tofacitinib: 35.9 [SD 12.1], p = 0.36) and sex (41% female in each group, p = 1.00). Medical characteristics were similar between groups except for biologic medication exposure 30 days before surgery (non-tofacitinib: 66%, tofacitinib: 36%, p = 0.004). Surgical characteristics did not differ between groups. Most patients were discharged on extended venous thromboembolism prophylaxis (non-tofacitinib: 80% and tofacitinib: 77%). Adjusted for biologic exposure, there were no statistically significant differences in venous thromboembolism (non-tofacitinib exposed: 14%, tofacitinib-exposed: 4%, p = 0.09) or other postoperative outcomes., Limitation: Retrospective, single institutional study., Conclusion: Among patients with ulcerative colitis undergoing total colectomy or proctocolectomy, exposure to tofacitinib was not associated with an increased risk of venous thromboembolism or other postoperative complications. See Video Abstract., Competing Interests: Financial Disclosures: The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Colon and Rectal Surgeons.)