Problems in roentgen diagnosis of sigmoid volvulus
Xingrong, C.; Baoshu, X.
Chinese Medical Journal 92(7): 483-490
1979
ISSN/ISBN: 0366-6999 PMID: 114373 Document Number: 149621
Studies on 66 cases of volvulus of the sigmoid colon are reported. Some problems in roentgen diagnosis and treatment are discussed. A few cases of sigmoid volvulus are of the non-closed loop obstruction type which can be confirmed by Ba enema. Its clinical manifestation, method of treatment and prognosis are quite different from those in the closed loop obstruction type. When the torsion of the closed loop type is less than 360.degree., the direction and degree of torsion can be inferred from the direction of the tapered end of the Ba column and the location of Ba which has partly entered the twisted loop. With a 180.degree. clockwise torsion, the beak points to the left and the small amount of Ba in the twisted loop is shifted to the left. With a counterclockwise torsion near to 360.degree., the beak points to the right, and the few Ba in the twisted loop shifts to the right. The X-ray findings may be helpful in prognosis and selection of treatment. There are 6 atypical signs which may be seen on plain films in the closed loop obstruction type. Some of these signs may be observed simultaneously. As long as the basic characteristics are kept in mind, most cases can be diagnosed by plain films of the abdomen.