More colonic dilitation…


This patient presented with abdominal pain, nausea, vomiting, and distention:

Volvulus 1 Volvulus 2 Cecal Volvulus 2 Cecal Volvulus

These films and CT show colonic dilatation similar to last week (sigmoid volvulus).  However, in contrast to last week, this is a cecal volvulus.  In this CT there is marked dilatation of the cecum with a central location in the abdomen.  Usually a cecal volvulus will have visible haustra as opposed to a sigmoid volvulus in which colonic haustra will not be present.  Sometimes, as in the above images, the haustra are difficult to see.  This also looks like it may be a more rare form of cecal volvulus called a cecal bascule.  For more information I will defer to our radiology colleagues at Radiopaedia:

Caecal Volvulus

For all you radiologists out there, do you think this is consistent with a cecal bascule?

Why note the difference between cecal and sigmoid volvulus?  The treatment can be drastically different.  Sigmoid volvuli are many times amenable to acute management non-operatively (sigmoidoscopy) whereas cecal volvuli usually require open laparotomy and have a higher frequency of partial colectomy.

Author:  Russell Jones, MD

References

1.   Gaillard F et al.  Caecal Volvulus. http://radiopaedia.org/articles/caecal_volvulus

Advertisements

About emrems411

EMREMS: Radiology in Emergency Medicine

View all posts by emrems411

Subscribe to EMREMS

Subscribe to our RSS feed and social profiles to receive updates.

No comments yet.

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s

%d bloggers like this: