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Pictorial Interlude: caught up in a 'whirl'
Marianne Kuehnast1, Savvas Andronikou
1Department of Diagnostic Radiology, University of the Witwatersrand, Johannesburg. drmkuehnast@gmail.com
Summary
The "whirl sign" on computed tomography (CT) significantly increases the likelihood of needing surgery for small-bowel obstruction (SBO). This CT finding is a crucial indicator for assessing patients with suspected SBO.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Assessment
Background:
- Small-bowel obstruction (SBO) is a common surgical emergency.
- Accurate and timely diagnosis of SBO is critical for patient outcomes.
- Computed tomography (CT) is a primary imaging modality for evaluating SBO.
Observation:
- The 'whirl sign' is a specific radiological finding observed on CT scans.
- This sign represents the twisting of mesenteric structures.
- Its presence has been correlated with specific pathologies within the small bowel.
Findings:
- Patients exhibiting the 'whirl sign' on CT are 25.3 times more likely to require surgical intervention for SBO compared to those without.
- The 'whirl sign' demonstrates high predictive value for surgically significant SBO.
Implications:
- The 'whirl sign' serves as a vital diagnostic clue in the assessment of SBO.
- Incorporating the 'whirl sign' into diagnostic algorithms can improve surgical decision-making.
- Enhanced recognition of this sign can lead to more efficient patient management and potentially reduce surgical delays.
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