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BackgroundUltrasonographic visualisation of the mesenteric vasculature of the large colon (LC) from the right side of the abdomen in cases of displacement and volvulus has been described. However, the LC can move freely within the abdomen and its mesentery can potentially contact both sides of the abdominal wall.MethodsThirty-four horses presented with LC-related colic that had visible LC mesenteric vasculature visible on abdominal ultrasound were included. A control group was made including horses with confirmed small intestinal-related colic. The objective of this study was to evaluate the visibility of LC mesenteric vasculature with transabdominal ultrasonography in horses with LC-related colic and to determine its diagnostic value.ResultsThe LC mesenteric vasculature was identified on the right side of the abdomen in 16/34 horses with right dorsal displacement of the LC (RDDLC), 180° LC volvulus (LCV), 540° LCV or LC impaction. On the left side of the abdomen, LC mesenteric vessels were identified in 17/34 horses with left dorsal displacement of the LC (LDDLC), 180° LCV or RDDLC. Vessels were visualised on both sides in one horse with a 180° LCV. Presence of LC mesenteric vasculature in the dorsal aspect on the left side of the abdomen was significantly associated with LDDLC.ConclusionLC mesenteric vasculature can be visualised on transabdominal ultrasound from either side of the abdomen in horses with different forms of LC-related colic.

Sigmoid volvulus occurs when a portion of sigmoid colon twists around its blood supply at the base of the mesentery, causing ischemia and necrosis. In developed nations, this is most commonly a condition of elderly, bed-bound, chronically constipated individuals. However, this condition may occur after blunt abdominal trauma, especially in individuals with underlying anatomic derangements from the aforementioned conditions. We present a unique case of sigmoid volvulus in a patient with no pre-existing abdominal complaints or surgical history, who sustained blunt traumatic injuries when she was struck by a motor vehicle. Prompt recognition of this deadly condition by emergency clinicians facilitated rapid surgical correction and mitigated further morbidity and mortality.

Background Colonic volvulus, a condition in which a colonic segment partially twists around its base, is the third leading cause of large bowel obstruction after colonic neoplasms and diverticular disease. However, volvulus of the transverse colon is the rarest type of large intestinal volvulus. Moreover, the occurrence of transverse colonic volvulus secondary to a benign tumor originating from outside the intestine has never been reported. We hereby report a case of transverse colonic volvulus caused by mesenteric fibromatosis. Case presentation A 53-year-old female with a history of rheumatoid arthritis and thyroid tumor presented with abdominal pain for 1 day. Abdominal computed tomography revealed intestinal torsion at the hepatic flexure. Twisted and obstructed mucosa of the transverse colon was observed during colonoscopy, but no tumor invasion of the mucosal surface was detected. A solid mass of a mesenteric origin with involvement of the transverse colon was observed during surgery. The mass was diagnosed surgically as transverse colonic volvulus induced by a mesenteric tumor. Hence, the patient underwent a right hemicolectomy. Histopathological results indicated mesenteric desmoid-type fibromatosis. The postoperative recovery was uneventful, and the patient was discharged 8 days after surgery. Conclusions Although mesenteric fibromatosis is rare, this disease should be considered when managing transverse colonic volvulus resulting from nonmucosal tumors.

Transverse colonic volvulus is exceptionally rare and is the rarest compared to sigmoid or cecal volvulus. This case report summarizes the care of a young 19-year-old woman who presented with transverse colonic volvulus. This woman came to the emergency room with abdominal pain, nausea, and vomiting, and she had no risk factors for a volvulus. This case report has the goal of raising awareness among those taking care of anyone coming in for abdominal pain. Volvulus is a serious issue and can be life threatening if not treated appropriately.

Background Colonic volvulus is rare in children and associated with colonic dysmotility. Diagnosis of colonic volvulus on radiographs in these patients can be challenging. The purpose of the study was to identify the accuracy of abdominal radiographs and findings suggestive of colonic volvulus. Materials and methods A retrospective (2003- 2014) study of all children with colonic volvulus proven surgically or endoscopically reviewed their medical charts for underlying disease and clinical presentation as well as their original radiograph reports. Two pediatric radiologists (reader 1 and reader 2) independently reviewed the radiographs. The kappa test was used to evaluate interobserver variability. Results There were 19 cases of colonic volvulus in 18 patients (11 males) a mean age 14 years. Cecal volvulus was the most common finding at 14/19 cases (74%). Sixteen of 18 (89%) patients had neurological impairment and 10 of 18 (56%) had intestinal dysmotility. The most common presentation was abdominal distension (14/19 [74%]) and pain (11/19 [58%]). Colonic volvulus was diagnosed in only 7/16 (44%) of the abdominal radiographs. The specific finding of a coffee-bean sign was retrospectively observed only by reader 2 in two cases. Absence of rectal gas and focal colonic loop dilation were the most common findings by the readers (average 73.5% and 87%, respectively) with Kappa values of 0.3 and 0.38, respectively. Conclusion Diagnosis of colonic volvulus in children can be challenging. Radiologists should be alerted to the possibility of colonic volvulus when there is focal colonic loop distention or absent rectal gas.

Colonic volvulus (CV) is a rare but potentially life-threatening condition with unclear etiopathogenesis. To date, less than 80 pediatric cases have been described. Hirschsprung’s disease (HD) is associated with CV in 17% of cases, representing a significant risk factor. Non-HD CV is an even more complex entity. The aim of this study is to describe a series of patients with CV to accentuate some peculiar aspects of this disease. We performed a retrospective study (period: 2012–2021) collecting information of patients with CV. Data analyzed included: demographics, medical history, presenting symptoms and radiological and surgical details. Eleven patients (12.5 ± 2.8 years; 7F/4M) had CV (eight sigmoid, two transverse colon, one total colon). Five patients had associated anomalies and three had HD. A two-step approach with volvulus endoscopic/radiological detorsion followed by intestinal resection was attempted in eight cases (one endoscopic approach failed). Three patients required surgery at admission. At follow-up, two patients developed recurrent intestinal obstruction, one of whom also had anastomotic stenosis. Colonic volvulus is a challenging condition that requires prompt patient care. A missed diagnosis could lead to severe complications. The evaluation of the patient should include a careful histological examination (searching for HD and alpha-actin deficiency), immunologic and metabolic screening, neurological tests and detection of chronic intestinal pseudo-obstruction (CIPO). Lifelong follow-up is mandatory for the early recognition and treatment of progressive diseases involving the proximal gastrointestinal tract.

Any segment of the colon can be affected by volvulus; however, sigmoid is most commonly affected (60-75%), followed by the caecum (25-40%), transverse colon (1-4%) and splenic flexure (1%).1 Various rare associations of caecal volvulus have been made with abdominal/ pelvic pathologies such as bowel cancer, acute cholecystitis, abdominoplasty, pregnancy, ventral hernia, endometriosis and uterine leiomyoma.1,2 Herein, we present a case of large bowel obstruction from caecal volvulus which was likely precipitated by the use of an opioid for analgesia after a dental procedure, highlighting the importance of thinking out-of-the-box and not just zeroing in on constipation. With the background history of chronic constipation in the current case, the use of an opioid prolongs the colonic transit time, which may have been the precipitating factor for the colonic volvulus.3 An anatomical predisposition has been noted where there is a lack of parietal fixation of the ileocaecal region during embryological counterclockwise caecal rotation from the left side of abdomen towards the right iliac fossa.1 As a result of the embryological predisposition, caecal volvulus maybe part of the spectrum of conditions that includes mobile right colon. Key CT findings of caecal volvulus include the \"CT coffee bean,\" \"bird beak\" and \"whirl sign\" (Figure 2b).1 Surgical options for caecal volvulus include singlestage primary ileo-colic resection and anastomosis or a two-staged procedure with delayed ileo-colic anastomosis following a period of temporary double-barrelled stoma.

A 31-yr-old male Sumatran orangutan (Pongo abelii) presented with 14 yr of chronic purulent nasal drainage and cough with intermittent exacerbation of symptoms requiring systemic antibiotic treatment. He was diagnosed with a cystic fibrosis (CF)-like condition. Evaluation consisted of bronchoscopy with bronchoalveolar lavage, culture, and computed tomography scanning of the sinuses and chest. Although the presence of low fecal elastase activity increased the suspicion for a diagnosis of CF, pilocarpine iontophoresis with sweat collection and analysis (“sweat testing”) was inconclusive. Medical management included twice-daily nebulization with bronchodilators and alternating month inhaled antibiotics, pancreatic enzyme replacement therapy, and simethicone as needed. Sinopulmonary and gastrointestinal symptoms improved substantially with treatment. Several years later, the animal died acutely of colonic volvulus. Necropsy and histopathology confirmed CF-like lung disease with chronic air sacculitis.

Large-bowel obstruction (LBO) is a relatively common abdominal emergency. Computed tomography (CT) diagnosis of LBO is often easy, but it is essential to clarify LBO etiology and to decide how to treat it. Therefore, it is important for the radiologist to become familiar with the imaging findings of LBO, including plain radiography and CT, to determine its various causes, as well as the many diseases mimicking LBO. In this article, we show the characteristics of radiological findings of plain radiograph, barium study, and CT and their correlations with pathologic findings. LBO etiology comprises two main categories: neoplastic and nonneoplastic disease. However, the primary causes of LBO are neoplastic etiologies, and nonneoplastic causes are relatively uncommon and unfamiliar to many radiologists in clinical practice. Therefore, in this review, we present nonneoplastic etiology of LBO and diseases simulating LBO and provide critical information concerning the causes of LBO and viability of the involved bowel loops.