Cecal volvulus: The CT whirl sign

Frank, Adam; Goffner, Lori; Fruauff, Arthur A.; Losada, Richard

doi:10.1007/bf00198126

Cited by 74 publications

(24 citation statements)

References 6 publications

(14 reference statements)

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“…Some authors reported that it is possible to diagnose cecal volvulus when CT shows a collapsed or compressed sigmoid colon with the whirl sign. 13 In reviewing our patient's X-ray fi lms, we noted haustra in the dilated colon; however, the ileum did not appear dilated, and the ileocecal valve was not seen in the right side of the A C B Fig. 3.…”

Section: Discussionmentioning

confidence: 81%

Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: Report of a case

et al. 2008

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A 44-year-old woman was admitted to our hospital for investigation and treatment of sudden abdominal pain and distention. Plain abdominal radiography and abdominal computed tomography (CT) findings were suggestive of sigmoid volvulus. She underwent an emergency colonoscopy, and the scope passed easily through the sigmoid colon and reached the ascending colon quickly. However, stenosis with concentricity of the fold was observed in the cecum, which was shifted upward and to the left. Based on these findings, we diagnosed cecal volvulus caused by mobile cecum syndrome. The patient's symptoms resolved quickly after colonoscopic reduction and elective laparoscopic surgery was performed 18 days after admission. Perioperative examination revealed a mobile cecum caused by an elongated ascending colon. We sutured the cecum and ascending colon to the lateral peritoneum laparoscopically with interrupted sutures. The patient recovered well and was discharged on postoperative day 7. An unfixed intestine can be detected easily during laparoscopic surgery, which is minimally invasive and cosmetically, physically, and economically beneficial. Thus, we recommend laparoscopic cecopexy for mobile cecum syndrome.

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Section: Discussionmentioning

confidence: 81%

Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: Report of a case

et al. 2008

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“…1C and 1E), which was originally described in the midgut by Fisher [6]. Subsequently, this sign was found to be helpful in diagnosing sigmoid [7] and cecal [8] volvulus. The whirl is composed of tightly twisted bowel, mesentery, and vessels.…”

Section: Discussionmentioning

confidence: 99%

CT Diagnosis of Volvulus of the Descending Colon with Persistent Mesocolon

Chen

Yang

Shih

et al. 2003

American Journal of Roentgenology

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Paragonimiasis is prevalent in Far East anda kind of endemic Korean diseases. The primary site of human paragonimiasis is the lung, but the ectopic infection of lung fluke has been reported by many authors. We experienced one case of abdominal paragonimiasis in a 44 year old male with a complaint of left lower quadrant pain. Physical examination, barium enema, and other data suggested the possibility of tumor originating from the wall of descending colon. (intramural tumor). Postoperative specimen, taken from the solid tumorous lesion showed parasitic granuloma, characteristic of Paragonimus Westermani. Here, we report a case of very peculiar ectopic paragonimiasis involved descending colon wall simulating neoplastic tumor, and also review the literatures briefly .

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“…1 Similar ischemic changes follow cessation of hepatic blood flow during the course of tumor resection, hepatic transplantation, and transarterial embolization. 1,2,8 As the portal vein contributes susceptible to hypoxic injury. However, as the O 2 saturation at emergency was not low enough to cause ischemic hepatitis by itself and as the level did not differ significantly from the levels in the patient just after discharge, it is possible that the sudden decrease in portal blood flow was the additional factor that allowed the threshold for initiation of ischemic liver damage to be reached.…”

Section: Discussionmentioning

confidence: 99%

“…Liver biopsy on the 15th hospital day revealed moderate collapse of hepatic acini and Chest X-ray examination revealed bilateral emphysematous lungs without pulmonary infiltration or cardiomegaly. Computed tomography showed a whirling pattern 8,9 anterior to the abdominal aorta at the level of the umbilicus (Fig. 1), suggesting mesenteric volvulus.…”

Section: Introductionmentioning

confidence: 99%

Ischemic hepatitis induced by mesenteric volvulus in a patient with chronic obstructive lung disease

Nakajima¹,

Konishi²,

Sakamoto³

et al. 2000

Journal of Gastroenterology

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A 66-year-old man with chronic obstructive lung disease was admitted to our hospital, presenting with mesenteric volvulus and mild liver injury. A superior mesenteric angiogram revealed that the arteries supplying the small intestine were twisted in the arterial phase, while the portal vein was not visualized in the late phase. A celiac angiogram demonstrated that portal blood flow from the splenic venous return was maintained. The patient's symptoms had almost resolved the day after admission, and his serum transaminases level had gradually decreased to normal with conservative therapy. A superior mesenteric angiogram on the 13th hospital day showed a normal arteriogram and the portal vein demonstrated blood flow from the superior mesenteric vein. Liver biopsy revealed hemorrhagic necrosis around the central veins, which was compatible with ischemic hepatitis. Since the patient's O2 saturation level on admission was not low enough to have caused ischemic hepatitis by itself, we suspect that a sudden decrease in portal blood flow was the additional factor that allowed the threshold for the initiation of ischemic liver damage to be reached.

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Cecal volvulus: The CT whirl sign

Cited by 74 publications

References 6 publications

Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: Report of a case

Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: Report of a case

CT Diagnosis of Volvulus of the Descending Colon with Persistent Mesocolon

Ischemic hepatitis induced by mesenteric volvulus in a patient with chronic obstructive lung disease

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