Abdominal twists and turns: part I, gastrointestinal tract torsions with pathologic correlation

The gastrointestinal tract is secured in place by various suspensory ligaments. Laxity or incomplete development of these anchoring ligaments can lead to hypermobility and predispose the patient to torsion-related ischemic pathology. A prompt diagnosis is necessary to avoid life-threatening consequences of prolonged visceral ischemia. Abdominal torsions are rarely diagnosed clinically, and it is often the responsibility of the radiologist to recognize and make the diagnosis through radiography, fluoroscopy, or cross-sectional imaging. This article reviews the imaging spectrum (with radiologic-pathologic correlations) and therapeutic implications of gastrointestinal tract torsions.

Torsion-related ischemic pathology may involve any portion of the gastrointestinal tract from the stomach to the colon. The clinical presentation of gastrointestinal tract torsion is nonspecific, and radiologists are relied on to make this diagnosis. Recognition of the predisposing factors and imaging spectrum of gastrointestinal tract torsions is essential to help direct timely intervention in these potentially life-threatening entities.