Hosting 708 files, 2884 images, and 4 contributors.

 
Random Case

Term Ischemia
Joseph Junewick, MD FACR
over 5 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Sigmoid Volvulus 1

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 2 years ago
Updated: over 2 years ago
Tags: PEDS
Modality/Study Types: CR FL
Activities:
Adobe32 PDF Imagej32 ImageJA

History

12 year old male with recurrent abdominal pain.


Case Images


Diagnosis

Sigmoid Volvulus

Findings

CR – Upright radiograph shows a markedly dilated loop of bowel in the low midline abdomen with air-fluid levels.

FL – Contrast opacifies the sigmoid colon with longitudinal twist clearly demonstrated.

Discussion

Sigmoid volvulus represents a closed loop obstruction that can result in bowel ischemia. It is usually an acquired condition seen in patients with chronic constipation who abuse laxatives but it is also seen in patients with conditions such as Parkinson disease, multiple sclerosis, Alzheimer disease, pseudobulbar palsy, schizophrenia, pregnancy, high fiber diets and Chagas disease. Clinical manifestations are abdominal pain, gradual or acute abdominal bloating, constipation, and vomiting although it is not uncommon for a patient to appear healthy despite dramatic bowel distention. In nearly half of all cases, there is a history of previous attacks. Differential diagnoses include pseudo-obstruction from laxatives or pain medications, distended transverse colon, cecal volvulus. Prompt decompression with a rectal tube or enema; surgical fixation decreases recurrence rate.

Reference

Feldman D. The coffee bean sign. Radiology (2000); 216:178-179.



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare