Cecal volvulus - MedPix® Medical Image Database and Teaching Files

38.107.191.111

Disease Topic 1608
(Reviewed and Approved) :: Link to this Topic

Click Here for MedPix®-2

» » - - - - « «

Contributor: James M. Messmer, MD

Scroll to Bottom to Display Images (if available)

Cecal volvulus
Factoid 1608 - Created: 2001-04-02 08:22:02-04 - Modified: 2004-04-23 20:33:42-04

ACR Codes: 7.-1
When the ascending colon fails to be fixed into the right abdomen, excessive mobility may occur which can allow for torsion and displacement of the ascending colon into the left upper quadrant. The term cecal volvulus is somewhat of a misnomer since the point of torsion is usually well above the ileocecal valve. This abnormality represents approximately 1 to 3% of cases of intestinal obstruction in adults and may occur as a sudden abdominal emergency. Mobility of the cecum is not uncommon in asymptomatic patients, which suggests that for torsion to occur there should be an underlying precipitating condition. In approximately one-third of cases there will be evidence of an obstruction distal to the torsion.

There are two types of torsion of the ascending colon. Axial torsion is more common and may be from 180 to 360 degrees along the longitudinal axis of the colon. Plain film findings suggestive of cecal volvulus can be seen in the majority of patients. The cecum is disproportionately distended and occupies the central abdomen or left upper quadrant. Haustrations usually are preserved. The small bowel may be lateral to the cecum. Three quarters of patients have air fluid levels in the cecum. Barium enema examination demonstrates a "beak" at the point of torsion similar to that seen with a sigmoid volvulus.

Cecal bascule is a less common cause for cecal and ascending colon distension. In this condition, the cecum folds anteriorly and medially in front of the ascending colon causing a flap valve occlusion at the site of flexion. A barium enema may show barium entering the cecum and may reduce the distended colon. A precipitating factor for formation of the cecal bascule is adhesive bands across the ascending colon.

In the classic case, the differential diagnosis is limited to axial torsion or a cecal bascule. Other segments of colon may be dilated and mimic a distended cecum. Diffuse colonic ileus, Ogilvie's syndrome, will show colonic dilatation distally either to the level of the splenic flexure or beyond. When the small bowel is markedly dilated, the diagnosis of cecal volvulus may be obscured.

- || -

Location: Gastrointestinal	Sublocation: Colon	Category: Obstruction or Stenosis
- Find Related Topics: Click on the Location, Sublocation, or Category Links Above

Send this Search to ...

- CHORUS - - Google™

Written by: James M. Messmer, MD
Prepared by: Gastrointestinal Learning File - © ACR
Affiliation: ACR Learning File® - || -
Approved by: James G. Smirniotopoulos, M.D.
Affiliation: Uniformed Services University - || -

Use this for Comments and Suggestions

MedPix® is sponsored by the Department of Radiology and Radiological Sciences, USUHS, Bethesda, MD
We do not accept paid advertisements.

We comply with the HONcode standard
for trustworthy health information:
verify here.

Text and Images may be Copyrighted © 1999 - 2009 by the Original Content Contributors.
Copyrighted materials are reproduced here with their Permission.
MedPix® is a Registered Trademark of USUHS :: The MedPix® Database Engine is Patented - USPTO No. 7,080,098
Portions of MedPix® are Copyright © 1999 - 2009 by J.G. Smirniotopoulos, M.D. & H. Irvine, M.D.
The MedPix® Classification Schema Copyright © 1999 - 2009 by J.G.Smirniotopoulos,M.D.

MedPix® has displayed more than 266,868,518 pages since 3 September 2000.

Database Successfully Disconnected