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[Small bowell volvulus - combined radiological findings].
F Lassandro1, S Giovine, A Pinto
1II e I Servizio di Radiologia, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Naples, Italy.
La Radiologia Medica
|October 26, 2001
Summary
Radiography and CT scans effectively identified small bowel volvulus in 66 patients. While plain films showed obstruction signs, CT scans accurately revealed bowel wall necrosis, crucial for diagnosis.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Background:
- Small bowel volvulus is a rare but serious condition requiring prompt diagnosis.
- Radiological imaging plays a critical role in identifying the obstruction and associated complications.
Purpose of the Study:
- To retrospectively evaluate and compare the radiological findings of plain abdominal films, abdominal sonography, and abdominal computed tomography (CT) in patients with surgically confirmed small bowel volvulus.
Main Methods:
- Retrospective analysis of 66 patients with surgically proven small bowel volvulus.
- Review of plain abdominal films, abdominal ultrasound (US), and abdominal CT scans.
- Evaluation of specific imaging findings such as bowel loop dilatation, air-fluid levels, obstruction site, whirl sign, beak sign, and bowel wall/mesenteric alterations.
Main Results:
- Plain abdominal films revealed air-fluid levels in 92.4% and bowel loop dilatation in 71.2% of cases.
- Abdominal sonography showed bowel loop dilatation in 48.5% and extraluminal fluid in 48.5%.
- CT demonstrated bowel loop dilatation in 95.5%, bowel wall thickening in 78.8%, beak sign in 69.7%, and whirl sign in 13.6%.
Conclusions:
- Air-fluid levels and bowel loop dilatation are common findings in small bowel volvulus.
- Plain abdominal films are useful for detecting signs of obstruction.
- Abdominal CT is superior in identifying signs of bowel wall necrosis, a critical indicator of severity.