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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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Portal hypertension is an increase in blood pressure within the portal venous system. Normally, this pressure is less than 5 mmHg. It is considered clinically significant when it rises above 10 mmHg. At this threshold, complications from altered blood flow and venous congestion emerge.EtiologyPortal hypertension arises from conditions that impede blood flow through the liver. The most common cause is cirrhosis, in which chronic liver injury leads to fibrotic scarring. This fibrosis narrows or...
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Related Experiment Video

Updated: May 6, 2026

Author Spotlight: Advancing Hepatobiliary and Pancreatic Tumor Treatment with Minimally Invasive Surgical Techniques
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Left upper quadrant pain: upside down spleen.

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  • 1From the *Department of Radiology, and †Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX.

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Summary

A novel "upside down" spleen sign on coronal CT reconstruction aids in diagnosing splenic torsion, a rare cause of left upper quadrant pain. This imaging finding helps confirm the condition when other methods are inconclusive.

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Area of Science:

  • Radiology
  • Abdominal Imaging
  • Surgical Pathology

Background:

  • Splenic torsion is a rare condition causing acute abdominal pain.
  • Diagnosis can be challenging due to non-specific clinical presentations.

Observation:

  • A patient presented with left upper quadrant pain.
  • Initial plain films showed a left upper quadrant mass.
  • Computed tomography (CT) revealed a whorled pedicle, suggestive of torsion.

Findings:

  • Coronal reconstruction CT definitively demonstrated a 180-degree splenic torsion.
  • The "upside down" spleen sign on coronal CT was crucial for diagnosis.

Implications:

  • The "upside down" spleen sign offers a specific diagnostic clue for splenic torsion.
  • Enhanced CT imaging, particularly coronal reconstructions, is vital for identifying this condition.
  • Early diagnosis and surgical intervention are critical for managing splenic torsion.