Volvulus of the gastrointestinal tract：Diagnosis and management

Congress:

ECR 2018

Poster Number:

C-1406

Type:

Educational Exhibit

Keywords:

Acute, Diagnostic procedure, Digital radiography, CT, Colon, Abdomen

Authors:

K. Matsunari¹, T. Nagashima², N. Hashizume², N. Yagi², K. Watanabe³, S. Akashita⁴, K. Koyama², H. Fujisawa¹; ¹Kanagawa/JP, ²Yokohama/JP, ³Yokohama, JP/JP, ⁴KAWASAKI/JP

DOI:

10.1594/ecr2018/C-1406

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1406

Fig. 2: Type of malrotation.

Fig. 4: Gastric volvulus.

Fig. 6: Transverse colon volvulus.

Fig. 7: Radiographic images and Fluoroscopic image of Sigmoid volvulus.

Fig. 11: Cecum volvulus.

Learning objectives

To learn normal development and malrotation of the gastrointestinal tract. To know the different mechanism of volvulus. To know radiologic features and management of volvulus of the gastrointestinal tract.

Background

Volvulus of the gastrointestinal tract is one of the causes of acute or recurring abdominal pain. The clinical symptoms associated with volvulus are often nonspecific, and rarely diagnosed clinically. Because prompt diagnosis needs critical to avoid life-threatening complications of prolonged volvulus such as bowel ischemia and infarction, clinicians often consult radiologists for diagnostic evaluations. In many cases, volvulus of the gastrointestinal tract is diagnosed with these findings on radiography, fluoroscopy, and computed tomography. In cases with no evidence of peritonitis or ischemic bowel, treatment starts...

Findings and procedure details

1．Embryology of the gastrointestinal tract During normal abdominal development, the 3 divisions of the gastrointestinal tract (foregut, midgut, hindgut) herniate out from the abdominal cavity, where they then undergo a 270 agree counterclockwise rotation around the superior mesenteric vessels(1,2). Following this rotation, the bowels return to the abdominal cavity, with fixation of the duodenojejunal loop to the left of the midline and the cecum in the right lower quadrant(Fig.1). Intestinal malrotation, also known as intestinal nonrotation or incomplete rotation, refers to any variation in this...

Conclusion

Volvulus of the gastrointestinal tract is one of the causes of acute or recurring abdominal pain. To avoid complications, prompt diagnosis by radiologic evaluation including radiography and CT findings is important.

Personal information

References

Bastiaan W. Haak,a, Sander T. Bodewitz, Caroline F. Kuijper, and Louise M. de Widt-Levert. Intestinal malrotation and volvulus in adult life. Int J Surg Case Rep. 2014; 5(5): 259–261. Ballesteros Gómiz E, Torremadé Ayats A, Durán Feliubadaló C, Martín Martínez C, Caro Tarragó A. Intestinal malrotation--volvulus: imaging findings. Radiologia. 2015 Jan-Feb;57(1):9-21. Peterson CM, Anderson JS, Hara AK, Carenza JW, Menias CO. Volvulus of the gastrointestinal tract: appearances at multimodality imaging. Radiographics. 2009 Sep-Oct;29(5):1281-93. Fatih Altintoprak, Omer Yalkin, Enis Dikicier, Taner Kivilcim et al. A rare...