CT findings in five dogs with surgically confirmed colonic torsion

Abstract

Colonic torsion is a life‐threatening condition that results in colonic ischemia, necrosis, perforation, sepsis, and eventual death. The aim of this multicenter, retrospective case series study was to describe the CT findings in dogs with surgically confirmed colonic torsion. Medical records were searched for dogs with surgically confirmed colonic torsion following abdominal CT. Five dogs met the inclusion criteria. Three had a history of chronic intermittent diarrhea prior to presentation. Two dogs presented with acute vomiting, diarrhea, and abdominal pain and one dog presented with acute vomiting and lethargy. Computed tomographic findings in all dogs with surgically confirmed colonic torsion include: “whirl sign,” displacement and distension of the cecum and colon, focal narrowing of the colon, and distension of the mesenteric vasculature in all dogs (5/5); streaky peritoneal fat and peritoneal effusion (4/5), pneumatosis coli (2/5), small intestinal distension (2/5), portal vein thrombosis (1/5), and reduced colonic wall contrast enhancement (1/5). In all dogs (5/5), the torsion site was the descending colon and demonstrated an anticlockwise rotation. At surgery, three of the five dogs had a partial colonic torsion with hyperemia at the site of obstruction and two of the five dogs had a complete torsion with marked necrosis of the colonic wall. Displacement of the colon and cecum, segmental distension and focal narrowing of the colon, the presence of a “whirl sign” and distension of the mesenteric vasculature are CT findings highly suggestive of colonic torsion.

Computed tomographic and clinical findings in a dog with suspected liver lobe torsion, secondary disseminated intravascular coagulation and multiorgan infarction

“…The ‘whirl sign’ is a unique characteristic seen on CT which describes the path of twisted soft tissues around a point and is highly specific for diagnosing visceral torsion 17–19. It has been described in cases involving the spleen,23 gastrointestinal tract,17 24 urinary bladder25 and testicles,26 but never in relation to LLT. In the case presented here, the ‘whirl sign’ was due to the twisting of the left lateral lobe of the liver around its axis.…”

“…Ultrasonography and CT have been previously used in the work‐up of LLT,1 8–13 but diagnosis often relies on confirmation during surgery or postmortem 9. To the authors’ knowledge, this is the first case of a suspected LLT displaying a ‘whirl sign’ on CT, which is highly specific for diagnosing visceral torsion 17–19. The dog was presumptively diagnosed with disseminated intravascular coagulation (DIC) causing renal and myocardial infarction and pulmonary thromboembolism.…”

“…9 To the authors' knowledge, this is the first case of a suspected LLT displaying a 'whirl sign' on CT, which is highly specific for diagnosing visceral torsion. [17][18][19] The dog was presumptively diagnosed with disseminated intravascular coagulation (DIC) causing renal and myocardial infarction and pulmonary thromboembolism. This is also the first CT description of a presumed myocardial infarction in a dog.…”

Unilateral uterine torsion in two non‐gravid bitches: Imaging and histological features

“…In particular, the evidence of an arterial supply deriving from the uterine artery was indicative of the uterine origin of the mass-like lesion in both cases. Tomographic whirl sign is referred to the visualisation of whirling vessels, due to the torsion of the organs upon themselves, and has been previously reported in veterinary medicine in several cases of torsion of different organs, [11][12][13][14][15][16] but has never been described before in case of uterine horn torsion. The recognition of a whirl sign adjacent to the mass has been considered indicative for torsion in these two cases.…”

Intestinal Torsion and Volvulus Through a Mesenteric Rupture in a Bearded Dragon (Pogona vitticeps)

“…Diagnosis often requires imaging; for most first-opinion practices, this is a combination of radiography and ultrasonography. When available, computed tomography has also been used (Barge et al ., 2019). Quick and effective diagnosis results in a better prognosis for the patient.…”