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Gastrointestinal Imaging

E2569. Bowel Obstructions, With a Twist! A Review of Internal Hernias and Volvulus

Kuo F1,  Pahwa A1,2,  Masamed R1,  Kadell B1,  Patel M.1,2 1. Ronald Reagan University of California, Los Angeles Medical Center, , Los Angeles, CA; 2. Olive View- University of California, Los Angeles Medical Center, , Los Angeles, CA

Address correspondence to F. Kuo (FKuo@mednet.ucla.edu)

Background Information: Internal hernias and volvulus are rare but important causes of bowel obstruction and acute abdomen. Symptoms are often non-specific and diagnosis along with assessment of complications of bowel ischemia or infarction relies heavily on imaging.

Educational Goals/Teaching Points: On completing the case-based review of this educational exhibit, the radiologist should be familiar with clinical presentation, imaging characteristics, diagnostic workup, and management of internal hernias and volvulus.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The presentation will consist of comprehensive anatomic and multimodality imaging review (radiography, fluoroscopy, and CT) of internal hernias and volvulus in a multiple choice question format. Categories will include gastric volvulus (organoaxial and mesenteroaxial), cecal volvulus, sigmoid volvulus, small bowel and midgut volvulus, and internal hernias (transmesenteric, paraduodenal, and more).

Conclusion: Accurate recognition of volvulus and internal hernias is important especially when imaging is an essential component of the diagnosis and guidance of management. This multiple choice, case-based review of volvulus and internal hernias will assist radiologists and especially radiology trainees in identifying volvulus and internal hernias as causes of bowel obstruction and acute abdomen.