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A comprehensive radiologic review of abdominal and pelvic torsions

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Abstract

The clinical manifestations of abdominal and pelvic organ torsion can often be non-specific and can affect a wide range of ages and demographic groups. Radiologists have a key role in not only establishing the diagnosis of organ torsion, but also in the assessment of potential complications. As multiple imaging modalities may be utilized in the evaluation of abdominal and pelvic pain, recognizing the various appearances of organ torsion is important to ensure early diagnosis and thereby reducing patient morbidity and mortality, particularly since abdominal and pelvic organ torsion may not be clinically suspected at the time of initial patient presentation.

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References

  1. Akhtar A, Siddiqui FS, Sheikh AAE, Sheikh AB, Perisetti A (2018) Gastric Volvulus: A Rare Entity Case Report and Literature Review. Cureus 10 (3):e2312. https://doi.org/10.7759/cureus.2312

    Article  PubMed  PubMed Central  Google Scholar 

  2. Li X, Zhang J, Li B, Yi D, Zhang C, Sun N, Lv W, Jiao A (2017) Diagnosis, treatment and prognosis of small bowel volvulus in adults: A monocentric summary of a rare small intestinal obstruction. PLoS One 12 (4):e0175866. https://doi.org/10.1371/journal.pone.0175866

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Draus JM, Jr., Foley DS, Bond SJ (2007) Laparoscopic Ladd procedure: a minimally invasive approach to malrotation without midgut volvulus. Am Surg 73 (7):693-696

    Article  PubMed  Google Scholar 

  4. Martin MJ, Steele SR (2010) Twists and turns: a practical approach to volvulus and intussusception. Scand J Surg 99 (2):93-102. https://doi.org/10.1177/145749691009900210

    Article  CAS  PubMed  Google Scholar 

  5. Vogel JD, Feingold DL, Stewart DB, Turner JS, Boutros M, Chun J, Steele SR (2016) Clinical Practice Guidelines for Colon Volvulus and Acute Colonic Pseudo-Obstruction. Dis Colon Rectum 59 (7):589-600. https://doi.org/10.1097/dcr.0000000000000602

    Article  PubMed  Google Scholar 

  6. Consorti ET, Liu TH (2005) Diagnosis and treatment of caecal volvulus. Postgrad Med J 81 (962):772-776. https://doi.org/10.1136/pgmj.2005.035311

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. del-Pozo G, Albillos JC, Tejedor D, Calero R, Rasero M, de-la-Calle U, Lopez-Pacheco U (1999) Intussusception in children: current concepts in diagnosis and enema reduction. Radiographics 19 (2):299-319. https://doi.org/10.1148/radiographics.19.2.g99mr14299

  8. Valentini V, Buquicchio GL, Galluzzo M, Ianniello S, Di Grezia G, Ambrosio R, Trinci M, Miele V (2016) Intussusception in Adults: The Role of MDCT in the Identification of the Site and Cause of Obstruction. Gastroenterol Res Pract 2016:5623718. https://doi.org/10.1155/2016/5623718

    Article  PubMed  Google Scholar 

  9. Ha JP, Tang CN, Siu WT, Tsui KK, Li MK (2006) Laparoscopic management of acute torsion of the omentum in adults. Jsls 10 (3):351-354

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Navez B, d'Udekem Y, Cambier E, Richir C, de Pierpont B, Guiot P (1995) Laparoscopy for management of nontraumatic acute abdomen. World J Surg 19 (3):382–386; discussion 387. https://doi.org/10.1007/bf00299164

  11. van Breda Vriesman AC, Lohle PN, Coerkamp EG, Puylaert JB (1999) Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. Eur Radiol 9 (9):1886-1892. https://doi.org/10.1007/s003300050942

    Article  PubMed  Google Scholar 

  12. Matsubara K, Urushihara T, Oshita A, Itamoto T (2018) Single-incision laparoscopic cholecystectomy for gallbladder torsion: A case report and literature review. Asian J Endosc Surg 11 (2):165-168. https://doi.org/10.1111/ases.12435

    Article  PubMed  Google Scholar 

  13. Ezaki S, Tomimaru Y, Noguchi K, Noura S, Imamura H, Dono K (2019) Surgical Results of Laparoscopic Cholecystectomy for Gallbladder Torsion. Am Surg 85 (5):471-473

    Article  PubMed  Google Scholar 

  14. Gok M, Karakas SP (2010) Torsion of a splenule. Pediatr Radiol 40 Suppl 1:S88. https://doi.org/10.1007/s00247-010-1822-4

    Article  PubMed  Google Scholar 

  15. Lebron R, Self M, Mangram A, Dunn E (2008) Wandering spleen presenting as recurrent pancreatitis. Jsls 12 (3):310-313

    PubMed  PubMed Central  Google Scholar 

  16. Asafu Adjaye Frimpong G, Aboagye E, Ayisi-Boateng NK, Antwi K, Bawuah KA, Coleman NE, Nunoo AW, Danso DB, Amoah M, Kwofie B (2019) Concurrent occurrence of a wandering spleen, organoaxial gastric volvulus, pancreatic volvulus, and cholestasis - A rare cause of an acute abdomen. Radiol Case Rep 14 (8):946-951. https://doi.org/10.1016/j.radcr.2019.05.018

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ng MRA, McCullers M, Gamenthaler A (2019) Wandering Spleen with 720-degree Torsion Treated with Splenectomy and Distal Pancreatectomy. Am Surg 85 (8):e430-e432

    Article  PubMed  Google Scholar 

  18. Aswani Y, Anandpara KM, Hira P (2015) Wandering spleen with torsion causing pancreatic volvulus and associated intrathoracic gastric volvulus. An unusual triad and cause of acute abdominal pain. Jop 16 (1):78–80. https://doi.org/10.6092/1590-8577/2905

  19. Seif Amir Hosseini A, Streit U, Uhlig J, Biggemann L, Kahl F, Ahmed S, Markus D (2019) Splenic torsion with involvement of pancreas and descending colon in a 9-year-old boy. BJR Case Rep 5 (1):20180051. https://doi.org/10.1259/bjrcr.20180051

    Article  PubMed  Google Scholar 

  20. Barber NJ, Thompson PM (2004) Nephroptosis and nephropexy--hung up on the past? Eur Urol 46 (4):428-433. https://doi.org/10.1016/j.eururo.2004.03.023

    Article  CAS  PubMed  Google Scholar 

  21. Plas E, Daha K, Riedl CR, Hubner WA, Pfluger H (2001) Long-term followup after laparoscopic nephropexy for symptomatic nephroptosis. J Urol 166 (2):449-452

    Article  CAS  PubMed  Google Scholar 

  22. Pery R, Shaharabani E, Gazer B, Gutman M, Rosin D (2017) Laparoscopic Fixation for Torsion of Transplanted Kidney: A Case Report. Transplant Proc 49 (10):2378-2380. https://doi.org/10.1016/j.transproceed.2017.09.010

    Article  CAS  PubMed  Google Scholar 

  23. Sofue K, Vikraman DS, Jaffe TA, Chaubal GN, Bashir MR (2015) Graft Kidney Torsion After Simultaneous Kidney-Pancreas Transplant: Report of 2 Cases and Literature Review. J Comput Assist Tomogr 39 (4):506-509. https://doi.org/10.1097/rct.0000000000000250

    Article  PubMed  Google Scholar 

  24. Sosin M, Lumeh W, Cooper M (2014) Torsion of the retroperitoneal kidney: uncommon or underreported? Case Rep Transplant 2014:561506. https://doi.org/10.1155/2014/561506

    Article  PubMed  PubMed Central  Google Scholar 

  25. Serrano OK, Olowofela AS, Kandaswamy R, Riad S (2017) Long-term Graft Survival After Kidney Allograft Torsion: Rapid Diagnosis and Surgical Management Key to Reversibility of Injury. Transplant Proc 49 (7):1565-1569. https://doi.org/10.1016/j.transproceed.2017.04.005

    Article  CAS  PubMed  Google Scholar 

  26. Huchon C, Fauconnier A (2010) Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol 150 (1):8-12. https://doi.org/10.1016/j.ejogrb.2010.02.006

    Article  PubMed  Google Scholar 

  27. Katsumori T, Akazawa K, Mihara T (2005) Uterine artery embolization for pedunculated subserosal fibroids. AJR Am J Roentgenol 184 (2):399-402. https://doi.org/10.2214/ajr.184.2.01840399

    Article  PubMed  Google Scholar 

  28. Zaima A, Ash A (2011) Fibroid in pregnancy: characteristics, complications, and management. Postgrad Med J 87 (1034):819-828. https://doi.org/10.1136/postgradmedj-2011-130319

    Article  PubMed  Google Scholar 

  29. Avery LL, Scheinfeld MH (2013) Imaging of penile and scrotal emergencies. Radiographics 33 (3):721-740. https://doi.org/10.1148/rg.333125158

    Article  PubMed  Google Scholar 

  30. Duda JB, Bhatt S, Dogra VS (2008) Utility of CT whirl sign in guiding management of small-bowel obstruction. AJR Am J Roentgenol 191 (3):743-747. https://doi.org/10.2214/ajr.07.3386

    Article  PubMed  Google Scholar 

  31. Gollub MJ, Yoon S, Smith LM, Moskowitz CS (2006) Does the CT whirl sign really predict small bowel volvulus?: Experience in an oncologic population. J Comput Assist Tomogr 30 (1):25-32. https://doi.org/10.1097/01.rct.0000191680.28344.f0

    Article  PubMed  Google Scholar 

  32. Sodhi KS, Bhatia A, Saxena AK, Rao KL, Menon P, Khandelwal N (2014) Anticlockwise swirl of mesenteric vessels: a normal CT appearance, retrospective analysis of 200 pediatric patients. Eur J Radiol 83 (4):710-714. https://doi.org/10.1016/j.ejrad.2013.12.026

    Article  PubMed  Google Scholar 

  33. Shimanuki Y, Aihara T, Takano H, Moritani T, Oguma E, Kuroki H, Shibata A, Nozawa K, Ohkawara K, Hirata A, Imaizumi S (1996) Clockwise whirlpool sign at color Doppler US: an objective and definite sign of midgut volvulus. Radiology 199 (1):261-264. https://doi.org/10.1148/radiology.199.1.8633156

    Article  CAS  PubMed  Google Scholar 

  34. Menuck L (1976) Plain film findings of gastric volvulus herniating into the chest. AJR Am J Roentgenol 126 (6):1169-1174. https://doi.org/10.2214/ajr.126.6.1169

    Article  CAS  PubMed  Google Scholar 

  35. Godshall D, Mossallam U, Rosenbaum R (1999) Gastric volvulus: case report and review of the literature. J Emerg Med 17 (5):837-840. https://doi.org/10.1016/s0736-4679(99)00092-x

    Article  CAS  PubMed  Google Scholar 

  36. Mazaheri P, Ballard DH, Neal KA, Raptis DA, Shetty AS, Raptis CA, Mellnick VM (2019) CT of Gastric Volvulus: Interobserver Reliability, Radiologists' Accuracy, and Imaging Findings. AJR Am J Roentgenol 212 (1):103-108. https://doi.org/10.2214/ajr.18.20033

    Article  PubMed  Google Scholar 

  37. Peterson CM, Anderson JS, Hara AK, Carenza JW, Menias CO (2009) Volvulus of the gastrointestinal tract: appearances at multimodality imaging. Radiographics 29 (5):1281-1293. https://doi.org/10.1148/rg.295095011

    Article  PubMed  Google Scholar 

  38. Vaez-Zadeh K, Dutz W, Nowrooz-Zadeh M (1969) Volvulus of the small intestine in adults: a study of predisposing factors. Ann Surg 169 (2):265-271. https://doi.org/10.1097/00000658-196902000-00014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Roggo A, Ottinger LW (1992) Acute small bowel volvulus in adults. A sporadic form of strangulating intestinal obstruction. Ann Surg 216 (2):135–141. https://doi.org/10.1097/00000658-199208000-00003

  40. Coe TM, Chang DC, Sicklick JK (2015) Small bowel volvulus in the adult populace of the United States: results from a population-based study. Am J Surg 210 (2):201-210.e202. https://doi.org/10.1016/j.amjsurg.2014.12.048

    Article  PubMed  PubMed Central  Google Scholar 

  41. Butterworth WA, Butterworth JW (2018) An adult presentation of midgut volvulus secondary to intestinal malrotation: A case report and literature review. Int J Surg Case Rep 50:46-49. https://doi.org/10.1016/j.ijscr.2018.07.007

    Article  PubMed  PubMed Central  Google Scholar 

  42. Epelman M (2006) The whirlpool sign. Radiology 240 (3):910-911. https://doi.org/10.1148/radiol.2403040370

    Article  PubMed  Google Scholar 

  43. Taylor GA (2011) CT appearance of the duodenum and mesenteric vessels in children with normal and abnormal bowel rotation. Pediatr Radiol 41 (11):1378-1383. https://doi.org/10.1007/s00247-011-2118-z

    Article  PubMed  Google Scholar 

  44. McAlister WH, Kronemer KA (1996) Emergency gastrointestinal radiology of the newborn. Radiol Clin North Am 34 (4):819-844

    Article  CAS  PubMed  Google Scholar 

  45. Levsky JM, Den EI, DuBrow RA, Wolf EL, Rozenblit AM (2010) CT findings of sigmoid volvulus. AJR Am J Roentgenol 194 (1):136-143. https://doi.org/10.2214/ajr.09.2580

    Article  PubMed  Google Scholar 

  46. Javors BR, Baker SR, Miller JA (1999) The northern exposure sign: a newly described finding in sigmoid volvulus. AJR Am J Roentgenol 173 (3):571-574. https://doi.org/10.2214/ajr.173.3.10470881

    Article  CAS  PubMed  Google Scholar 

  47. Khurana B (2003) The whirl sign. Radiology 226 (1):69-70. https://doi.org/10.1148/radiol.2261011392

    Article  PubMed  Google Scholar 

  48. Vandendries C, Julles MC, Boulay-Coletta I, Loriau J, Zins M (2010) Diagnosis of colonic volvulus: findings on multidetector CT with three-dimensional reconstructions. Br J Radiol 83 (995):983-990. https://doi.org/10.1259/bjr/35714052

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Rosenblat JM, Rozenblit AM, Wolf EL, DuBrow RA, Den EI, Levsky JM (2010) Findings of cecal volvulus at CT. Radiology 256 (1):169-175. https://doi.org/10.1148/radiol.10092112

    Article  PubMed  Google Scholar 

  50. Wong M, Brooke Jeffrey R, Rucker AN, Olcott EW (2020) Ileocolic vascular curvature: a new CT finding of cecal volvulus. Abdom Radiol (NY) 45 (10):3057-3064. https://doi.org/10.1007/s00261-020-02491-w

    Article  Google Scholar 

  51. Y G, R A (2014) Omental torsion. J Clin Diagn Res 8 (6):Ne01–02. https://doi.org/10.7860/jcdr/2014/9024.4479

  52. Montiel-Jarquin A, Lopez-Colombo A, Nava A, Juarez-Santiesteban R, Leyva-Trejo H, Zamora-Ustaran A, Garcia-Carrasco M, Munoz-Guarneros M (2009) Clinical Characteristics of Torsion of the Omentum. Gastroenterology Res 2 (4):220-223. https://doi.org/10.4021/gr2009.07.1303

    Article  PubMed  PubMed Central  Google Scholar 

  53. Leitner MJ, Jordan CG, Spinner MH, Reese EC (1952) Torsion, infarction and hemorrhage of the omentum as a cause of acute abdominal distress. Ann Surg 135 (1):103-110. https://doi.org/10.1097/00000658-195201000-00014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Scabini S, Rimini E, Massobrio A, Romairone E, Linari C, Scordamaglia R, Marini LD, Ferrando V (2011) Primary omental torsion: A case report. World J Gastrointest Surg 3 (10):153-155. https://doi.org/10.4240/wjgs.v3.i10.153

    Article  PubMed  PubMed Central  Google Scholar 

  55. Ishimaru N, Maeno T (2012) Omental infarction triggered by tight pants. Intern Med 51 (16):2235-2237. https://doi.org/10.2169/internalmedicine.51.7823

    Article  PubMed  Google Scholar 

  56. Alexiou K, Ioannidis A, Drikos I, Sikalias N, Economou N (2015) Torsion of the greater omentum: two case reports. J Med Case Rep 9:160. https://doi.org/10.1186/s13256-015-0641-5

    Article  PubMed  PubMed Central  Google Scholar 

  57. Knoop M, Vorwerk T (2002) [Inflammatory alterations of the greater omentum--a difficult preoperative diagnosis]. Zentralbl Chir 127 (7):626-628. https://doi.org/10.1055/s-2002-32850

    Article  CAS  PubMed  Google Scholar 

  58. Naffaa LN, Shabb NS, Haddad MC (2003) CT findings of omental torsion and infarction: case report and review of the literature. Clin Imaging 27 (2):116-118. https://doi.org/10.1016/s0899-7071(02)00524-7

    Article  PubMed  Google Scholar 

  59. Puylaert JB (1992) Right-sided segmental infarction of the omentum: clinical, US, and CT findings. Radiology 185 (1):169-172. https://doi.org/10.1148/radiology.185.1.1523302

    Article  CAS  PubMed  Google Scholar 

  60. Schlesinger AE, Dorfman SR, Braverman RM (1999) Sonographic appearance of omental infarction in children. Pediatr Radiol 29 (8):598-601. https://doi.org/10.1007/s002470050657

    Article  CAS  PubMed  Google Scholar 

  61. Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA (2005) Acute epiploic appendagitis and its mimics. Radiographics 25 (6):1521-1534. https://doi.org/10.1148/rg.256055030

    Article  PubMed  Google Scholar 

  62. Reilly DJ, Kalogeropoulos G, Thiruchelvam D (2012) Torsion of the gallbladder: a systematic review. HPB (Oxford) 14 (10):669-672. https://doi.org/10.1111/j.1477-2574.2012.00513.x

    Article  Google Scholar 

  63. Kruijer MJ, Groh OR, de Bruine JH, Boom MJ, Verbeek PC (2010) [Torsion of the gallbladder]. Ned Tijdschr Geneeskd 154:A1796

    PubMed  Google Scholar 

  64. Ijaz S, Sritharan K, Russell N, Dar M, Bhatti T, Ormiston M (2008) Torsion of the gallbladder: a case report. J Med Case Rep 2:237. https://doi.org/10.1186/1752-1947-2-237

    Article  PubMed  PubMed Central  Google Scholar 

  65. Boonstra EA, van Etten B, Prins TR, Sieders E, van Leeuwen BL (2012) Torsion of the gallbladder. J Gastrointest Surg 16 (4):882-884. https://doi.org/10.1007/s11605-011-1712-6

    Article  PubMed  Google Scholar 

  66. Lemonick DM, Garvin R, Semins H (2006) Torsion of the gallbladder: a rare cause of acute cholecystitis. J Emerg Med 30 (4):397-401. https://doi.org/10.1016/j.jemermed.2005.07.011

    Article  PubMed  Google Scholar 

  67. Janakan G, Ayantunde AA, Hoque H (2008) Acute gallbladder torsion: an unexpected intraoperative finding. World J Emerg Surg 3:9. https://doi.org/10.1186/1749-7922-3-9

    Article  PubMed  PubMed Central  Google Scholar 

  68. Yeh HC, Weiss MF, Gerson CD (1989) Torsion of the gallbladder: the ultrasonographic features. J Clin Ultrasound 17 (2):123-125. https://doi.org/10.1002/jcu.1870170211

    Article  CAS  PubMed  Google Scholar 

  69. Usui M, Matsuda S, Suzuki H, Ogura Y (2000) Preoperative diagnosis of gallbladder torsion by magnetic resonance cholangiopancreatography. Scand J Gastroenterol 35 (2):218-222. https://doi.org/10.1080/003655200750024425

    Article  CAS  PubMed  Google Scholar 

  70. Herman TE, Siegel MJ (1991) CT of acute splenic torsion in children with wandering spleen. AJR Am J Roentgenol 156 (1):151-153. https://doi.org/10.2214/ajr.156.1.1898552

    Article  CAS  PubMed  Google Scholar 

  71. Sharma A, Salerno G (2014) A torted wandering spleen: a case report. J Med Case Rep 8:133. https://doi.org/10.1186/1752-1947-8-133

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Bouassida M, Sassi S, Chtourou MF, Bennani N, Baccari S, Chebbi F, Benali M, Mighri MM, Touinsi H, Sassi S (2012) A wandering spleen presenting as a hypogastric mass: case report. Pan Afr Med J 11:31

    PubMed  PubMed Central  Google Scholar 

  73. Chawla S, Boal DK, Dillon PW, Grenko RT (2003) Splenic torsion. Radiographics 23 (2):305-308. https://doi.org/10.1148/rg.232025110

    Article  PubMed  Google Scholar 

  74. Perez Fontan FJ, Soler R, Santos M, Facio I (2001) Accessory spleen torsion: US, CT and MR findings. Eur Radiol 11 (3):509-512. https://doi.org/10.1007/s003300000547

    Article  CAS  PubMed  Google Scholar 

  75. Gorsi U, Bhatia A, Gupta R, Bharathi S, Khandelwal N (2014) Pancreatic volvulus with wandering spleen and gastric volvulus: an unusual triad for acute abdomen in a surgical emergency. Saudi J Gastroenterol 20 (3):195-198. https://doi.org/10.4103/1319-3767.133026

    Article  PubMed  PubMed Central  Google Scholar 

  76. Flores-Rios E, Mendez-Diaz C, Rodriguez-Garcia E, Perez-Ramos T (2015) Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon. J Radiol Case Rep 9 (10):18-25. https://doi.org/10.3941/jrcr.v9i10.2475

    Article  PubMed  PubMed Central  Google Scholar 

  77. Sheflin JR, Lee CM, Kretchmar KA (1984) Torsion of wandering spleen and distal pancreas. AJR Am J Roentgenol 142 (1):100-101. https://doi.org/10.2214/ajr.142.1.100

    Article  CAS  PubMed  Google Scholar 

  78. Srirangam SJ, Pollard AJ, Adeyoju AA, O'Reilly PH (2009) Nephroptosis: seriously misunderstood? BJU Int 103 (3):296-300. https://doi.org/10.1111/j.1464-410X.2008.08082.x

    Article  PubMed  Google Scholar 

  79. Sobel DW, Jumper BM (2013) The case of the wandering kidney. Case Rep Urol 2013:498507. https://doi.org/10.1155/2013/498507

    Article  PubMed  PubMed Central  Google Scholar 

  80. Torabi J, Rocca JP, Choinski K, Lorenzen KA, Ajaimy M, Graham JA (2018) Renal Allograft Torsion Following Simultaneous Pancreas Kidney Transplant Should Be Suspected With Sustained Kidney Injury With Normal Pancreas Function. Prog Transplant 28 (4):396-397. https://doi.org/10.1177/1526924818800041

    Article  PubMed  Google Scholar 

  81. Dewan R, Dasyam AK, Tan H, Furlan A (2016) Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication. Case Rep Radiol 2016:4273780. https://doi.org/10.1155/2016/4273780

    Article  PubMed  PubMed Central  Google Scholar 

  82. Latchana N, Dowell JD, Al Taani J, Michaels A, Elkhammas E, Black SM (2015) Ultrasound-accelerated, catheter-directed thrombolysis for inferior vena cava thrombosis after an orthotopic liver transplant. Exp Clin Transplant 13 (1):96-99. https://doi.org/10.6002/ect.2013.0195

    Article  PubMed  Google Scholar 

  83. Jeng KS, Huang CC, Lin CK, Lin CC, Chen KH (2017) Graft calcification caused by a torsion of the hepatic vein after a living-related donor liver transplantation. Ann Hepatol 16 (1):164-168. https://doi.org/10.5604/16652681.1226954

    Article  PubMed  Google Scholar 

  84. Elsayes KM, Shaaban AM, Rothan SM, Javadi S, Madrazo BL, Castillo RP, Casillas VJ, Menias CO (2017) A Comprehensive Approach to Hepatic Vascular Disease. Radiographics 37 (3):813-836. https://doi.org/10.1148/rg.2017160161

    Article  PubMed  Google Scholar 

  85. Sequeira FW, Weber TR, Smith WL, Careskey JM, Cairo MS (1981) Budd-Chiari syndrome caused by hepatic torsion. AJR Am J Roentgenol 137 (2):393-394. https://doi.org/10.2214/ajr.137.2.393

    Article  CAS  PubMed  Google Scholar 

  86. Ssi-Yan-Kai G, Rivain AL, Trichot C, Morcelet MC, Prevot S, Deffieux X, De Laveaucoupet J (2018) What every radiologist should know about adnexal torsion. Emerg Radiol 25 (1):51-59. https://doi.org/10.1007/s10140-017-1549-8

    Article  PubMed  Google Scholar 

  87. Chang HC, Bhatt S, Dogra VS (2008) Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 28 (5):1355-1368. https://doi.org/10.1148/rg.285075130

    Article  PubMed  Google Scholar 

  88. Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N (2009) Cannot exclude torsion--a 15-year review. J Pediatr Surg 44 (6):1212–1216; discussion 1217. https://doi.org/10.1016/j.jpedsurg.2009.02.028

  89. Duigenan S, Oliva E, Lee SI (2012) Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. AJR Am J Roentgenol 198 (2):W122-131. https://doi.org/10.2214/ajr.10.7293

    Article  PubMed  Google Scholar 

  90. Lourenco AP, Swenson D, Tubbs RJ, Lazarus E (2014) Ovarian and tubal torsion: imaging findings on US, CT, and MRI. Emerg Radiol 21 (2):179-187. https://doi.org/10.1007/s10140-013-1163-3

    Article  PubMed  Google Scholar 

  91. Kupesic S, Plavsic BM (2010) Adnexal torsion: color Doppler and three-dimensional ultrasound. Abdom Imaging 35 (5):602-606. https://doi.org/10.1007/s00261-009-9573-0

    Article  PubMed  Google Scholar 

  92. Casey RK, Damle LF, Gomez-Lobo V (2013) Isolated fallopian tube torsion in pediatric and adolescent females: a retrospective review of 15 cases at a single institution. J Pediatr Adolesc Gynecol 26 (3):189-192. https://doi.org/10.1016/j.jpag.2013.02.010

    Article  PubMed  Google Scholar 

  93. Bulun SE (2013) Uterine fibroids. N Engl J Med 369 (14):1344-1355. https://doi.org/10.1056/NEJMra1209993

    Article  CAS  PubMed  Google Scholar 

  94. Lai YL, Chen YL, Chen CA, Cheng WF (2018) Torsion of pedunculated subserous uterine leiomyoma: A rare complication of a common disease. Taiwan J Obstet Gynecol 57 (2):300-303. https://doi.org/10.1016/j.tjog.2018.02.021

    Article  PubMed  Google Scholar 

  95. Charles K, Raoul K, Idrissa G, Diomande G, Serge B (2017) Torsion of Uterine Fibroid: A Rare Cause of Acute Pelvic Pain: About One Case. Gynecology & Obstetrics Case report 03. https://doi.org/10.21767/2471-8165.1000056

    Article  Google Scholar 

  96. Kim HG, Song YJ, Na YJ, Choi OH (2013) A case of torsion of a subserosal leiomyoma. J Menopausal Med 19 (3):147-150. https://doi.org/10.6118/jmm.2013.19.3.147

    Article  PubMed  PubMed Central  Google Scholar 

  97. Le D, Dey CB, Byun K (2020) Imaging findings of a torsed pedunculated uterine leiomyoma: A case report. Radiol Case Rep 15 (2):144-149. https://doi.org/10.1016/j.radcr.2019.11.001

    Article  PubMed  Google Scholar 

  98. Ohgiya Y, Seino N, Miyamoto S, Takeyama N, Hatano K, Munechika J, Ishizuka K, Hirose M, Ohike N, Hashimoto T, Sekizawa A, Gokan T (2018) CT features for diagnosing acute torsion of uterine subserosal leiomyoma. Jpn J Radiol 36 (3):209-214. https://doi.org/10.1007/s11604-017-0712-1

    Article  CAS  PubMed  Google Scholar 

  99. Mansbach JM, Forbes P, Peters C (2005) Testicular torsion and risk factors for orchiectomy. Arch Pediatr Adolesc Med 159 (12):1167-1171. https://doi.org/10.1001/archpedi.159.12.1167

    Article  PubMed  Google Scholar 

  100. Mejdoub I, Fourati M, Rekik S, Rebai N, Hadjslimen M, Mhiri MN (2018) Testicular torsion in older men: It must always be considered. Urol Case Rep 21:1-2. https://doi.org/10.1016/j.eucr.2018.08.003

    Article  PubMed  PubMed Central  Google Scholar 

  101. Cummings JM, Boullier JA, Sekhon D, Bose K (2002) Adult testicular torsion. J Urol 167 (5):2109-2110

    Article  PubMed  Google Scholar 

  102. Ludvigson AE, Beaule LT (2016) Urologic Emergencies. Surg Clin North Am 96 (3):407-424. https://doi.org/10.1016/j.suc.2016.02.001

    Article  PubMed  Google Scholar 

  103. Molokwu CN, Somani BK, Goodman CM (2011) Outcomes of scrotal exploration for acute scrotal pain suspicious of testicular torsion: a consecutive case series of 173 patients. BJU Int 107 (6):990-993. https://doi.org/10.1111/j.1464-410X.2010.09557.x

    Article  PubMed  Google Scholar 

  104. Aso C, Enriquez G, Fite M, Toran N, Piro C, Piqueras J, Lucaya J (2005) Gray-scale and color Doppler sonography of scrotal disorders in children: an update. Radiographics 25 (5):1197-1214. https://doi.org/10.1148/rg.255045109

    Article  PubMed  Google Scholar 

  105. Aboughalia H, Tang ER, Iyer RS (2020) Boggy pseudomass sonographic sign for testicular torsion. Abdominal Radiology. https://doi.org/10.1007/s00261-020-02784-0

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Dr. Alana Brown for her contribution of artworks featured in this manuscript.

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Authors and Affiliations

  1. Department of Radiology, Eastern Virginia Medical School, Sentara Norfolk General Hospital, Norfolk, VA, 23507, USA

    Richard Bonney, Rick Lussier & Courtney B. Dey

  2. Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM, 87131, USA

    Jonathan W. Revels

  3. Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East #1A71, Salt Lake City, UT, 84132, USA

    Sherry S. Wang

  4. Department of Radiology, NYU Winthrop Hospital, 259 First Street, Mineola, NY, 11501, USA

    Douglas S. Katz

  5. Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA, 98195, USA

    Mariam Moshiri

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  4. Rick Lussier
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In accordance with the Authorship and Co-authorship Requirements for Manuscripts Submitted to Biomedical Journals of International Committee of Medical Journal Editors (ICMJE), all the authors have made substantial contributions to: conception and design, drafting the article or revising it critically for important intellectual content, and final approval of the version submitted to the Journal.

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S.S.W.: Activities related to the present article: No relevant relationships. Activities not related to the present article: receive publication royalties from Amirsys. M.M: Activities related to the present article: No relevant relationships. Activities not related to the present article: receive research grant support from Philips Medical Imaging, and book publication royalties from Amirsys. R.B., J.W.R., R.L, C.B.D., D.K.: Nothing to disclose.

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Online Resource 1 – Same patient as Fig.1. 61-year-old woman with abdominal pain. Cine axial images of a CT of the abdomen and pelvis with IV contrast demonstrate twisting of the mesenteric vasculature, the “whirlpool sign”. No bowel obstruction or features of bowel ischemia were otherwise present. The patient was managed conservatively, and the symptoms resolved. In this case, no etiology for the “whirlpool sign” was found.(MP4 3931 kb)

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Bonney, R., Revels, J.W., Wang, S.S. et al. A comprehensive radiologic review of abdominal and pelvic torsions. Abdom Radiol 46, 2942–2960 (2021). https://doi.org/10.1007/s00261-020-02868-x

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