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- Cecum to the left of me, descending colon to the right! Here I am, stuck with a colonic torsion
Cecum to the left of me, descending colon to the right! Here I am, stuck with a colonic torsion
VRU 2017
Christine L. Gremillion, Mason Savage, Eli B. Cohen
Background
Colonic torsion, a life-threatening condition in dogs, involves twisting of the colon leading to ischemia, necrosis, and systemic complications. Despite its severity, detailed radiographic findings have been underreported. This retrospective case series aimed to describe radiographic and clinical findings in dogs with surgically confirmed or presumed colonic torsion, enhancing diagnostic accuracy and treatment timeliness.
Methods
The study reviewed cases from 2006 to 2016 at a veterinary medical college and telemedicine database. Inclusion required abdominal radiographs and surgical confirmation of colonic torsion. Radiographs were evaluated for specific displacements and abnormalities, and clinical data were collected from medical records. Positive contrast radiographs using barium enema were analyzed for additional diagnostic patterns.
Results
Fourteen dogs met inclusion criteria. Key radiographic findings included segmental colonic distention (14/14), displacement of the descending colon (14/14), cecum displacement (11/14), and focal narrowing of the colon (11/14). Clinical signs were nonspecific, with vomiting (12/14) and abdominal pain (8/14) being most common. Barium enema revealed "torsion signs" (helical striations in the narrowed colon). Surgical confirmation of torsion occurred in 64% of cases; the remaining showed severe colonic pathology, including necrosis or congestion.
Limitations
This study had a retrospective design and potential selection bias. Imaging parameters were inconsistently recorded, and not all cases had surgical confirmation of colonic torsion. Dynamic changes in torsion status between imaging and surgery complicated the assessment.
Conclusions
Colonic torsion in dogs is often characterized by nonspecific clinical signs and distinct radiographic features. Barium enema is a valuable tool for preoperative diagnosis. Early suspicion and surgical intervention are critical for favorable outcomes. Further studies are recommended to clarify the disease spectrum and refine diagnostic criteria.
Right lateral radiographs of the A, cranial and B, caudal abdomen and a ventrodorsal radiograph (C) of the abdomen of a patient withsurgically confirmed colonic torsion. Note the segmental distention of the colon with focal narrowing of the distal descending colon (arrow head).The cecum (CE) is displaced to the left of the vertebral column and the descending colon (DC) is displaced to the right of the vertebral column in theventrodorsal view
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