Volvulus CT: Difference between revisions
Jump to navigation
Jump to search
| Line 10: | Line 10: | ||
*A [[Computed tomography|CT]] scan can determine obstruction level, rule out other causes of [[abdominal pain]] and obstruction, and when pathology is not clear with a plain [[X-rays|x-ray]]. | *A [[Computed tomography|CT]] scan can determine obstruction level, rule out other causes of [[abdominal pain]] and obstruction, and when pathology is not clear with a plain [[X-rays|x-ray]]. | ||
**The following result of abdominal [[Computed tomography|CT]] is indicative of volvulus: | **The following result of abdominal [[Computed tomography|CT]] is indicative of volvulus: | ||
***[[Sigmoid colon|Sigmoid]] | ***[[Sigmoid colon|Sigmoid]], [[Cecum|cecal]], [[Ileus|ileal]] volvulus: | ||
****Whirl pattern signifying a dilated bowel | ****Whirl pattern signifying a dilated bowel | ||
****Bird beak appearance of afferent and efferent colonic segments | ****Bird beak appearance of afferent and efferent colonic segments | ||
| Line 22: | Line 22: | ||
**Diaphragmatic defects | **Diaphragmatic defects | ||
**Free air or fluid in the abdomen | **Free air or fluid in the abdomen | ||
**Other sources of symptoms within the abdominal cavity | **Other sources of symptoms within the abdominal cavity | ||
==References== | ==References== | ||
Revision as of 21:20, 28 December 2017
|
Volvulus Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Volvulus CT On the Web |
|
American Roentgen Ray Society Images of Volvulus CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
The initial investigation for volvulus can be a plain x-ray without contrast, or a CT scan. CT scan is useful in diagnosing volvulus when x-ray has been unfruitful. CT can also identify the level of obstruction and determine if bowel necrosis has occurred.
CT
- The abdominal CT should be performed when the patient presents with symptoms of abdominal pain, distension, constipation/obstipation and nausea.[1][2]
- A CT scan can determine obstruction level, rule out other causes of abdominal pain and obstruction, and when pathology is not clear with a plain x-ray.
- The following result of abdominal CT is indicative of volvulus:
- Sigmoid, cecal, ileal volvulus:
- Whirl pattern signifying a dilated bowel
- Bird beak appearance of afferent and efferent colonic segments
- Absence of rectal gas
- Separation of the sigmoid walls by adjacent mesenteric fat (split wall sign)
- Additional findings suggestive of bowel necrosis on CT:
- Presence of air in the intestines (pneumatosis intestinalis)
- Portal venous gas
- Loss of bowel wall enhancement
- Sigmoid, cecal, ileal volvulus:
- The following result of abdominal CT is indicative of volvulus:
- In addition to these findings, a CT scan may be useful in determining the following:
- Diaphragmatic defects
- Free air or fluid in the abdomen
- Other sources of symptoms within the abdominal cavity