Journal List > J Korean Soc Radiol > v.62(4) > 1086746

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Kim, Lee, Kim, Lee, Kim, and Song: Total Colonic Volvulus Followed by Mesenteroaxial Gastric Volvulus in a 24-year-old Female: A Case Report
Abdominal Radiology
Case Report

Journal of the Korean Society of Radiology 2010; 62(4): 369-372.

Published online: 30 April 2010

DOI: https://doi.org/10.3348/jksr.2010.62.4.369

Total Colonic Volvulus Followed by Mesenteroaxial Gastric Volvulus in a 24-year-old Female: A Case Report

Mi Kyung Kim, M.D., Jong Beum Lee, M.D., Gihyeon Kim, M.D., Hwa Yeon Lee, M.D., Yang Soo Kim, M.D., In Sup Song, M.D.

1Department of Radiology, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Korea.

Address reprint requests to: Jong Beum Lee, M.D., Department of Radiology, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, 224-1, Heukseok-dong, Dongjak-gu, Seoul 156-756, Korea. Tel. 82-2-6299-2665, Fax. 82-2-6263-1557, jblee130@gmail.com

Received 19 October 2009       Accepted 4 November 2009

Copyright © 2010 The Korean Society of Radiology

Abstract

A very rare case of multi-organ volvulus, serially involving the spleen, colon and stomach, is presented in a 24-year-old female patient with Down syndrome. This case is of interest because of the three different types of volvulus or torsion that occurred serially over thirteen years in the same patient. We report the imaging findings and suggest possible pathogenesis by a review of the operation record and literature.

Keywords: Stomach, Colon, Spleen Disesases, Stomach Volvulus, Torsion, Abnormality

Figures and Tables

Fig. 1

A. Supine simple abdomen shows markedly gaseous distension of the colon. Subsequent CT showed this was whole colon except the part of rectosigmoid colon. Air filled appendix is shown (arrow).

B-D. Contrast-enhanced axial CT scans. B. At the level of the liver dome, CT scan shows displaced stomach on right side of the liver and markedly distended colon with poorly enhanced wall. C. At the level of SMA origin, CT scan shows markedly distended colon with poorly enhanced wall. Note gas distended appendix on the right side. D. At the level 2 cm below C, CT scan shows totally obliterated SMA (arrow).
E. Erect simple abdomen shows severely distended stomach with air-fluid level.
F. Coronal reformatted CT reveals that the esophagogastric junction (short arrow) is below the pylorus (long arrows). The CT was undertaken after emergent gastric decompression through the nasogastric tube. Note the nasogastric tube within the esophagogastric junction.
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References

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