How do you detect a volvulus on an X-ray?
How do you detect a volvulus on an X-ray?
If more fluid than air is in the obstructed loop of the sigmoid, the volvulus may be demonstrable by a soft-tissue mass or a pseudotumor sign. A dilated sigmoid colon that ascends to the transverse colon (northern exposure sign) is said to be a reliable sign of a sigmoid volvulus on a supine abdominal radiograph.
What does volvulus look like on xray?
Plain radiograph Abdominal radiographs will show a large, dilated loop of the colon, often with a few gas-fluid levels. Specific signs include: coffee bean sign. Frimann-Dahl sign – three dense lines converge towards the site of obstruction.
How do you identify a sigmoid volvulus?
Most often sigmoid volvulus presents with sudden-onset colicky lower abdominal pain associated with gross abdominal distension and a failure to pass either flatus or stool. It may present insidiously with chronic abdominal distension, constipation, vague and usually colicky lower abdominal discomfort and vomiting.
How can you tell the difference between sigmoid and cecal volvulus on X-ray?
Radiographic imaging can help differentiate between a sigmoid and cecal volvulus from other abdominal pathologies. For a cecal volvulus, an abdominal x-ray will reveal a dramatic dilation of bowel extending from the right lower quadrant moving upwards to the left upper quadrant of the abdomen (Figure 1).
How is volvulus diagnosed?
Diagnosis of volvulus will typically require traditional x-rays and imaging, during which time doctors will look for a telltale “coffee bean” shape or “bent inner tube” shape in the bowel. A barium enema may also be performed in order to enhance the imaging of the potential obstruction.
What is a sigmoid volvulus?
Pathophysiology — Sigmoid volvulus occurs when an air-filled loop of the sigmoid colon twists about its mesentery. Obstruction of the intestinal lumen and impairment of vascular perfusion occur when the degree of torsion exceeds 180 and 360 degrees, respectively [24].
What is the difference between intussusception and volvulus?
Intussusception refers to invagination or telescoping of a part of the intestine into itself, and malrotation volvulus is a congenital anomaly that results when the normal sequence of rotation and fixation of the bowel fails, which may result in intestinal obstruction.
How does a sigmoid volvulus present?
In sigmoid volvulus, this occurs at the base of the mesentery. It most commonly presents in patients who are bedbound and have a history of chronic constipation. Patients may demonstrate a loss of appetite, diminished or absent bowel output, and worsening abdominal distension.
What is difference between torsion and volvulus?
Intestinal torsion describes the twisting of the bowel on its longitudinal axis, causing luminal obstruction, whilst intestinal volvulus describes a rotation about the mesenteric axis.
What is the most common location of a volvulus?
The most common sites of volvulus are the sigmoid colon and cecum [1-4]. Volvulus of other portions of the alimentary tract, such as the stomach, gallbladder, small bowel, splenic flexure, and transverse colon, are rare.
