Purpose or Case Report: Introduction

Torsion or volvulus of upper abdominal viscera is rare and related to incomplete development and laxity of suspensory ligaments, or to poorly developed supernumerary accessory lobes. Clinical symptoms at presentation can be confusing and nonspecific, yet prompt recognition is essential to avoid life-threatening complications. Radiologists play an essential role in prompt recognition of these conditions. Our exhibit will review congenital anomalies of upper abdominal solid viscera that can lead to volvulus within an embryologic and anatomic framework. As examples, we include cases of mesenteroaxial gastric volvulus (Figure 1), torsion of an accessory hepatic lobe (Figure 2), and splenic torsion in the setting of polysplenia (Figure 3). Our cases include radiologic-pathologic correlations and therapeutic implications of solid visceral torsions.

Table of Contents/Outline:

Review of the embryology and anatomy of upper abdominal organs including a detailed pictorial of suspensory and anchoring ligaments.
Review and examples of types of gastric volvulus and treatment.

Review of variants of liver anatomy and of incidence and location of accessory hepatic lobes, with examples.

Review of splenic anatomy and normal variants, splenic torsion and gross malformations including variants seen in heterotaxy, with review of treatment options in splenic torsion, including observation, surgical pexy or resection.

Review of associated congenital anomalies (e.g. omphalocele, diaphragmatic hernia, and malrotation, etc.)
Methods & Materials:
Results:
Conclusions: