Significant plain film findings in sigmoid volvulus.
The aim of this study was to evaluate the plain abdominal radiographs of patients thought clinically to have a sigmoid volvulus. Strict diagnostic criteria based on the findings at barium enema and/or surgery were applied to establish or refute a diagnosis of sigmoid volvulus. The presenting plain abdominal radiographs were assessed for 10 radiological signs considered valuable in the diagnosis of sigmoid volvulus. Of the 17 patients with a volvulus, 88% had 6 or more signs, and in the 5 patients without a volvulus, 80% had 4 signs or less. Five signs achieved significance in differentiating between the groups. Three signs, apex of the loop under the left hemi-diaphragm, inferior convergence on the left and the left flank overlap sign, were 100% specific as well as being highly sensitive. The signs which were least specific were a distended ahaustral sigmoid loop and an air fluid ratio greater than 2:1.
Department of Radiology, University Hospital, Nottingham.
H C
HC
Burrell
D M
DM
Baker
P
P
Wardrop
A J
AJ
Evans
D012809:Colon, Sigmoid / Q000000981:diagnostic imaging; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D011859:Radiography; D012680:Sensitivity and Specificity; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging*