Gallbladder torsion, also known as volvulus, is a rare condition that can be fatal unless surgery is performed expediently.AWe report a case of gallbladder torsion. A 92-year-old woman presented with acute abdominal pain. Laboratory parameters were all within normal limits, with the exception of leukocytosis. Plain abdominal radiography showed no remarkable findings. Abdominal CT revealed an abnormal gallbladder with wall thickening, suggesting the presence of acute cholecystitis. At operation, the gallbladder was twisted, and the wall of was thickened with acute inflammation. We report the details of this case along with a review of the literature.
Abdominal Pain ; Cholecystitis, Acute ; Female ; Gallbladder ; Humans ; Inflammation ; Intestinal Volvulus ; Leukocytosis ; Radiography, Abdominal

PURPOSE: The purpose of this study is to evaluate the radiologic findings of the intestinal obstruction in the neonate according to the causes and to determine the findings useful for the differential diagnosis. MATERIALS AND METHODS: The materials consisted of 29 neonates with surgically proven gastrointestinal tract obstruction. We analized simple abdominal radiography and barium study comparing with the operative findings. RESULTS: The causes of intestinal obstruction were gastric atresia in 1 case, duodenal atresia in 3 cases, small bowel atresia in 11 cases(jejunal ;3 cases, ileal ;8 cases), colonic atresia in 2 cases, Hirschsprung's disease in 9 cases, ano-rectal anomaly in 6 cases, midgut volvulus in 2 cases, and Meckel's diverticulum in 1 case. Vomiting was noted in the all cases. The abdominal distension was not noted in the cases of gastric atresia, duodenal atresia, and proximal jejunal atresia. The meconium passage was noted in 2 cases of ileal atresia and 3 cases of Hirschsprung's disease. On barium study, site of obstruction was predicted accurately in gastric atresia, duodenal atresia, proximal jejunal atresia, and colonic atresia but it was not possible in distal jejunal atresia and ileal atresia. The microcolon was noted in 2 cases of jejunal atresia, 4 cases of ileal atresia, and 2 cases of colonic atresia. Out of 9 Hirschsprung's disease transition zones were seen on rectum or rectosigmoid junction in 7 cases and barium study was normal in 2 cases. CONCLUSION: In the diagnosis of neonatal intestinal obstruction, the basic radiologic studies such as simple abdominal radiography and gastrointestinal contrast study was useful for the differential diagnosis of the proxireal bowel loop atresia colonic ateria, and midgut volvulus.
Barium ; Colon ; Diagnosis ; Diagnosis, Differential ; Gastrointestinal Tract ; Hirschsprung Disease ; Humans ; Infant, Newborn* ; Intestinal Atresia ; Intestinal Obstruction* ; Intestinal Volvulus ; Meckel Diverticulum ; Meconium ; Radiography, Abdominal ; Rectum ; Vomiting

Intestinal malrotation is a congenital disorder that results from the failure of normal bowel rotation and fixation during the 5th gestational week. The incidence of intestinal malrotation is <0.2%, but prompt diagnosis is important because this anomaly can cause midgut volvulus and lead to fatalities. Compared to infants presenting with acute symptoms, such as abdominal pain, vomiting, or diarrhea, adult patients complain of intermittent self-limited abdominal pain. We present a case of intestinal malrotation complicated by midgut volvulus improved with conservative care in a 70-year-old man. The diagnosis was suggested on the basis of imaging findings.
Aged ; Angiography ; Colonic Diseases/*diagnosis/radiography ; Diagnosis, Differential ; Humans ; Intestinal Volvulus/*diagnosis/radiography ; Male ; Mesenteric Artery, Superior/radiography ; Tomography, X-Ray Computed

Although the color Doppler ultrasonography diagnosis of intestinal malrotation with midgut volvulus, based on the typical "whirlpool" appearance of the mesenteric vascular structures is well-defined in the peer-reviewed literature, the combination of both the angiographic illustration of these findings and the contemporary state-of-the-art imaging techniques is lacking. We report the digital subtraction angiography and multidetector computed tomography angiography findings of a 37-year-old male with intestinal malrotation.
Adult ; *Angiography, Digital Subtraction ; Contrast Media ; Diagnosis, Differential ; Humans ; Intestinal Volvulus/*radiography ; Iohexol/diagnostic use ; Male ; Mesentery/blood supply/*radiography ; *Tomography, X-Ray Computed ; Torsion Abnormality/*radiography

Intestinal malrotation is a developmental anomaly resulting from embryologic failure of fixation and rotation of the gut and predisposed to midgut vovulus and small bowel obstruction. Although various forms of malrotation anomalies in the gut can occur, nonrotation of prearterial segment with the initial symptomatic presentation at advanced age has been rarely reported. Here, we report a case of nonrotation of the prearterial segment of the midgut presenting with duodenal obstruction in a 60-year-old man. To our best knowledge, this is the first case reported about nonrotation of prearterial segment of the midgut in Korea.
Diagnosis, Differential ; Duodenal Obstruction/*diagnosis/surgery ; Humans ; Intestinal Volvulus/*diagnosis/radiography ; Intestine, Small/*abnormalities/embryology/pathology ; Male ; Middle Aged ; Rotation ; Tomography, X-Ray Computed

Splenic flexure volvulus is the least common form of colonic volvulus. Preoperative radiological diagnosis is usually made presumptively, based on plain radiographs and/or barium contrast enema study in patients presenting with acute large bowel obstruction. We report a case in which multidetector computer tomography (CT) findings were diagnostic of this condition, thus highlighting the usefulness of multiplanar reformatting.
Adult ; Colon, Transverse ; diagnostic imaging ; surgery ; Colonoscopy ; Digestive System Surgical Procedures ; Female ; Humans ; Intestinal Volvulus ; diagnosis ; diagnostic imaging ; surgery ; Multidetector Computed Tomography ; Radiography, Abdominal ; Treatment Outcome

The eventration of diaphragm is usually found incidentally on chest X-ray or sometimes presented as acute gastric volvulus. However, colonic volvulus on splenic flexure area complicated by diaphragmatic eventration is extremely rare. A 25 year old man complained of upper abdominal pain for three days. He had a history of brain injury during infant period, and had epilepsy and mental retardation. Plain chest X-ray showed left diaphragmatic eventration and marked dilatation of colon on splenic flexure area which had not been changed for last three years. Barium enema showed bird beak appearance on distal colon near the splenic flexure. Colonoscopic reduction failed. After decompression with rectal and nasogastric tubes, colonic volvulus was relieved. To prevent the recurrence of volvulus, we performed segmental resection of left colon including splenic flexure area and repaired the left diaphragmatic eventration. After the operation, the patient had no further recurrent episode of volvulus although ileus persisted.
Adult ; Barium Sulfate/diagnostic use ; Chronic Disease ; *Colon, Transverse ; Colonic Diseases/*radiography/surgery ; Diaphragmatic Eventration/*complications/radiography/surgery ; Humans ; Intestinal Volvulus/etiology/*radiography/surgery ; Male ; Recurrence ; Tomography, X-Ray Computed

Mesenteric lymphangiomas are rare abdominal masses that are seldom associated with small bowel volvulus, and especially in adult patients. We report here on an unusual case of small bowel volvulus that was induced by a mesenteric lymphangioma in a 43-year-old man who suffered from repeated bouts of abdominal pain. At multidetector CT, we noticed whirling of the cystic mesenteric mass and the adjacent small bowel around the superior mesenteric artery. Small bowel volvulus induced by the rotation of the mesenteric lymphangioma was found on exploratory laparotomy. Lymphangioma should be considered as a rare cause of small bowel volvulus in adult patients.
Abdominal Pain/etiology ; Adult ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Humans ; Intestinal Volvulus/*diagnosis/etiology/surgery ; Intestine, Small/*radiography/surgery ; Lymphangioma/*complications/surgery ; Male ; Mesenteric Artery, Superior/*radiography/surgery ; Radiographic Image Enhancement/methods ; Rare Diseases ; Tomography, X-Ray Computed

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.
Abdomen, Acute ; Barium ; Birth Weight ; Brain Ischemia ; Child* ; Diagnosis, Differential ; Down Syndrome ; Enema ; Female ; Gestational Age ; Heart ; Humans ; Infant ; Infarction ; Intestinal Volvulus* ; Mortality ; Radiography ; Retrospective Studies ; Short Bowel Syndrome ; Upper Gastrointestinal Tract ; Vomiting