Abdominal twists and turns: part 2, solid visceral torsions with pathologic correlation.

Objective: The solid abdominal viscera are secured in place by various suspensory ligaments. Laxity or incomplete development of these anchoring ligaments can lead to hypermobility and predispose the patient to torsion-related ischemic pathology. The clinical symptoms of solid visceral intraabdominal torsions are nonspecific. A prompt diagnosis is critical to avoid life-threatening consequences of prolonged visceral ischemia. Abdominal torsions are rarely diagnosed clinically, and it is often the responsibility of the radiologist to recognize and make the diagnosis through cross-sectional imaging. This article reviews the imaging spectrum, radiologic-pathologic correlations, and therapeutic implications of solid visceral intraabdominal torsions, including some unusual solid organ and abdominal fat torsions.

Conclusion: The clinical presentation of solid visceral intraabdominal torsion is nonspecific and radiologists are relied on to make this diagnosis on cross-sectional imaging studies. Recognition of the predisposing factors and imaging spectrum of intraabdominal torsions is essential to help direct timely intervention in these potentially life-threatening entities.