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Published in: European Radiology 12/2014

01-12-2014 | Gastrointestinal

Computed tomography findings of acute gastric volvulus

Authors: Ingrid Millet, Celine Orliac, Chakib Alili, Françoise Guillon, Patrice Taourel

Published in: European Radiology | Issue 12/2014

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Abstract

Purpose

To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects.

Materials and methods

We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated.

Results

The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100 % sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology.

Conclusion

CT is both highly sensitive and specific for diagnosing acute gastric volvulus.

Key Points

CT is highly reliable for diagnosing acute gastric volvulus with two findings.
The two signs are gastropyloric transition zone and abnormal location of the antrum.
This allows fast surgical management of this emergency.
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Metadata
Title
Computed tomography findings of acute gastric volvulus
Authors
Ingrid Millet
Celine Orliac
Chakib Alili
Françoise Guillon
Patrice Taourel
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3319-2

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