Cecal volvulus: what the radiologist needs to know

Cecal volvulus is a quite rare pathologic condition and therefore sometimes misdiagnosed, but is indeed more common than thought. It occurs with aspecific acute onset abdominal pain associated to nausea and vomiting, so that it often poses a diagnostic challenge for the clinician who needs radiological consultation for further evaluation. As cecal volvulus represents a cause of intestinal obstruction, radiologists have to recognize it at multimodality imaging in order to obtain a prompt diagnosis, suggest the adequate treatment and avoid severe complications. Thus, it is fundamental to be familiar with cecal volvulus appearance, especially at first level investigation: in fact abdominal plain film radiography is often sufficient to suspect the diagnosis and to require a confirmation with Computed Tomography (CT). This pictorial essay highlights cecal volvulus features, the importance of typical imaging findings pointing out X-ray/CTcorrelation, the management strategies and gives some warnings about its way of mimicking other diseases.