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Computed tomographic findings of small-bowel volvulus
1Department of Radiology, University of Iowa College of Medicine, Iowa City.
Radiation Medicine
|July 1, 1992
Summary
Computed tomography (CT) can reveal key signs of small-bowel volvulus, a twisting of the intestine often caused by adhesions. These CT findings include specific mesenteric changes and potential vascular patterns, aiding diagnosis in acute abdominal cases.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Small-bowel volvulus is a surgical emergency requiring prompt diagnosis.
- Adhesions are a common cause of secondary small-bowel volvulus.
- Computed tomography (CT) is a crucial imaging modality for evaluating acute abdominal conditions.
Observation:
- Review of two cases of small-bowel volvulus diagnosed via CT and confirmed at laparotomy.
- CT revealed focal, wedge-shaped, edematous mesentery with trapped fluid.
- Mesenteric changes radiated towards the site of torsion; one case showed the superior mesenteric vein (SMV) spiraling around the superior mesenteric artery (SMA).
Findings:
- CT findings were consistent with secondary small-bowel volvulus due to adhesions.
- Ischemic changes in the small-bowel loops were confirmed intraoperatively.
- Specific CT signs include mesenteric edema, fluid trapping, and characteristic vascular arrangements (e.g., "whirl sign" of SMV/SMA).
Implications:
- CT can provide suggestive findings for small-bowel volvulus in patients presenting with acute abdomen.
- Early CT diagnosis can facilitate timely surgical intervention, potentially reducing complications like bowel ischemia.
- Understanding these specific CT patterns improves diagnostic accuracy for this critical condition.