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Strangulated small bowel obstruction related to chronic torsion of an epiploic appendix: CT findings

A Osadchy, MD, M Shapiro-Feinberg, MD and R Zissin, MD

Department of Diagnostic Imaging, Meir Hospital, Sapir Medical Center, Kfar-Saba, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel



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  		Figure 1. (a) Contrast enhanced CT at mid abdomen level shows distended small bowel loops, contrast-filled loops without mural thickening, and fluid-filled, thick-walled loops, with engorged mesenteric vessels (black arrowheads) indicating volvulus. Note the collapsed small bowel loops in the right abdomen, distal to the strangulating obstruction (white arrow). (b) At the pelvis, dilated, thick-walled small bowel loops with a radial distribution converge towards a mass in the right lower quadrant (arrow). Note the mesenteric haziness. (c) Image 1.5 cm caudal to (b) shows the complexity of the mass (white arrow), consisting of soft tissue, fat (black arrowhead) and peripheral calcified flecks.

 




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