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[Cecal volvulus: imaging features].
Radiologia 2010 Jul-Aug; 52(4):333-41R

Abstract

OBJECTIVE

To determine the sensitivity of plain-film radiography and computed tomography (CT) in the diagnosis of cecal volvulus.

MATERIAL AND METHODS

We reviewed the clinical histories of 11 patients diagnosed with cecal volvulus at endoscopy or surgery. Two radiologists working in consensus analyzed the findings at plain-film radiography and at CT and calculated the sensitivities. The plain-film and CT studies were retrospectively classified as certain, probable, or indeterminate for cecal volvulus on the basis of the presence or absence of previously reported signs. Signs of wall suffering at CT were compared to the histologic findings.

RESULTS

The most sensitive findings at plain-film radiography were the presence of a disproportionately dilated bowel loop and a pattern of distal small bowel occlusion (91%), followed by a single air-fluid level in the cecum and collapse of the distal colon (82%). At CT, the "coffee bean" sign with a single air-fluid level and collapse of the left colon had a sensitivity of 100%. The whirl sign was present in 86%. Retrospectively, 36% of the plain-film studies and 86% of the CT studies were classified as certain for cecal volvulus. Although all cases with ischemia had signs of vascular compromise on CT, no significant correlation was observed between these variables.

CONCLUSIONS

The plain-film signs reported for cecal volvulus enable a certain diagnosis in a third of all cases; the CT signs enable a certain diagnosis in most cases. The evaluation of additional findings increases the chances of reaching the correct diagnosis.

Authors+Show Affiliations

Servicio de Radiodiagnóstico, Hospital Universitario Dr. Peset, Valencia, España. azulena@msn.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

spa

PubMed ID

20546819

Citation

López Pérez, E, et al. "[Cecal Volvulus: Imaging Features]." Radiologia, vol. 52, no. 4, 2010, pp. 333-41.
López Pérez E, Martínez Pérez MJ, Ripollés González T, et al. [Cecal volvulus: imaging features]. Radiologia. 2010;52(4):333-41.
López Pérez, E., Martínez Pérez, M. J., Ripollés González, T., Vila Miralles, R., & Flors Blasco, L. (2010). [Cecal volvulus: imaging features]. Radiologia, 52(4), pp. 333-41. doi:10.1016/j.rx.2010.03.014.
López Pérez E, et al. [Cecal Volvulus: Imaging Features]. Radiologia. 2010;52(4):333-41. PubMed PMID: 20546819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Cecal volvulus: imaging features]. AU - López Pérez,E, AU - Martínez Pérez,M J, AU - Ripollés González,T, AU - Vila Miralles,R, AU - Flors Blasco,L, Y1 - 2010/05/23/ PY - 2009/12/16/received PY - 2010/03/14/revised PY - 2010/03/28/accepted PY - 2010/6/16/entrez PY - 2010/6/16/pubmed PY - 2010/12/14/medline SP - 333 EP - 41 JF - Radiologia JO - Radiologia VL - 52 IS - 4 N2 - OBJECTIVE: To determine the sensitivity of plain-film radiography and computed tomography (CT) in the diagnosis of cecal volvulus. MATERIAL AND METHODS: We reviewed the clinical histories of 11 patients diagnosed with cecal volvulus at endoscopy or surgery. Two radiologists working in consensus analyzed the findings at plain-film radiography and at CT and calculated the sensitivities. The plain-film and CT studies were retrospectively classified as certain, probable, or indeterminate for cecal volvulus on the basis of the presence or absence of previously reported signs. Signs of wall suffering at CT were compared to the histologic findings. RESULTS: The most sensitive findings at plain-film radiography were the presence of a disproportionately dilated bowel loop and a pattern of distal small bowel occlusion (91%), followed by a single air-fluid level in the cecum and collapse of the distal colon (82%). At CT, the "coffee bean" sign with a single air-fluid level and collapse of the left colon had a sensitivity of 100%. The whirl sign was present in 86%. Retrospectively, 36% of the plain-film studies and 86% of the CT studies were classified as certain for cecal volvulus. Although all cases with ischemia had signs of vascular compromise on CT, no significant correlation was observed between these variables. CONCLUSIONS: The plain-film signs reported for cecal volvulus enable a certain diagnosis in a third of all cases; the CT signs enable a certain diagnosis in most cases. The evaluation of additional findings increases the chances of reaching the correct diagnosis. SN - 0033-8338 UR - https://www.unboundmedicine.com/medline/citation/20546819/[Cecal_volvulus:_imaging_features]_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0033-8338(10)00163-3 DB - PRIME DP - Unbound Medicine ER -