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Intestinal volvulus: angiographic findings

S Kadir, C A Athanasoulis, A J Greenfield

    Radiology
    |September 1, 1978
    PubMed

    Insights

    Intestinal volvulus can cause intestinal ischemia, often misdiagnosed on angiography. Recognizing the "whirlpool sign" on imaging is key for accurate diagnosis and timely treatment of this condition.

    Area of Science:

    • Radiology
    • Gastroenterology
    • Surgical Pathology

    Background:

    • Intestinal ischemia is a critical condition often requiring prompt diagnosis and intervention.
    • Intestinal volvulus, a twisting of the bowel, can be an underlying cause of intestinal ischemia.
    • Angiography is a common diagnostic tool for evaluating intestinal ischemia.

    Observation:

    • Angiographic findings suggestive of volvulus were misinterpreted as occlusive or nonocclusive ischemia in 3 out of 4 patients.
    • In one patient, angiography correctly suggested volvulus as the underlying cause of ischemia.
    • Specific angiographic signs of volvulus include a "whirlpool" pattern of mesenteric arteries, delayed arterial filling/emptying, and intense bowel wall opacification.

    Findings:

    • Angiography can reveal signs of intestinal volvulus that may be mistaken for other forms of intestinal ischemia.
    • The characteristic "whirlpool sign" and associated vascular findings on angiography are crucial indicators of volvulus.
    • Accurate interpretation of angiographic findings is essential for differentiating volvulus from other causes of ischemia.

    Implications:

    • Early and accurate diagnosis of intestinal volvulus via angiography can prevent delays in surgical intervention.
    • Familiarity with the angiographic presentation of volvulus improves diagnostic accuracy in cases of intestinal ischemia.
    • Prompt treatment initiated based on correct angiographic diagnosis can improve patient outcomes in intestinal volvulus.

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