J Korean Soc Radiol.  2010 Apr;62(4):369-372. 10.3348/jksr.2010.62.4.369.

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

• Kim MK
• Lee JB
• Kim G
• Lee HY
• Kim YS
• Song IS

• KMID: 1460071
• DOI: http://doi.org/10.3348/jksr.2010.62.4.369

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.

MeSH Terms

Colon
Down Syndrome
Female
Humans
Intestinal Volvulus
Spleen
Stomach
Stomach Volvulus
Young Adult

Figure

• 

  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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