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Caecal volvulus: a frequently missed diagnosis?
Clinical Radiology
|January 1, 1984
Summary
Plain abdominal radiographs can help diagnose acute caecal volvulus, a condition requiring prompt surgical treatment. Retrospective review showed a high missed diagnosis rate, emphasizing the need for radiologist awareness of characteristic radiographic signs.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Background:
- Acute caecal volvulus is a surgical emergency.
- Delayed diagnosis can lead to caecal gangrene and increased mortality.
Purpose of the Study:
- To evaluate the diagnostic accuracy of plain abdominal radiographs in acute caecal volvulus.
- To identify characteristic radiographic findings and potential diagnostic challenges.
Main Methods:
- Retrospective review of 45 plain abdominal radiographs from 58 patients with confirmed acute caecal volvulus.
- Analysis of radiographic features and comparison with clinical diagnoses.
Main Results:
- Plain abdominal radiographs were obtained in 55 patients (95%).
- Initial diagnosis was suspected in 29 patients (53%).
- Retrospective review identified diagnostic signs in 40 of 45 reviewed radiographs (89%).
- Characteristic findings include a comma-shaped, haustrated, dilated caecum, often centrally or in the left upper quadrant.
- Diagnostic difficulties arose in cases with peritonitis or small bowel dilatation.
Conclusions:
- Plain abdominal radiographs are valuable for diagnosing acute caecal volvulus.
- Radiologists should be aware of the characteristic radiographic signs to improve diagnostic accuracy.
- Prompt diagnosis and surgical intervention are crucial to prevent complications and reduce mortality.