Radiology Case of the Week: X-ray & CT of Cecal Volvulus - a podcast by Daniel J. Kowal, MD

In this inaugural case of the week radiology lecture, we discuss the imaging appearance of cecal volvulus!

Key points include:



* Cecal volvulus occurs when there is twisting of cecum around the mesentery with proximal large bowel obstruction.

* Cecum normally <9 cm, rest of large bowel <6 cm.

* Topogram (scout view) extremely helpful.

* Vector typically points towards LUQ, but instead of worrying about vector direction, look for proximal dilated small bowel (as opposed to large bowel) to differentiate from sigmoid volvulus.

* Complications include pneumoperitoneum = bowel perforation (Rigler’s sign, falciform ligament sign) and pneumatosis = cecal ischemia.

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