CHẨN ĐOÁN HÌNH ẢNH XOẮN TẠNG TRONG CẤP CỨU NHI KHOA

Abstract

Background: Organ torsion in pediatric emergencies represents a spectrum of acute conditions that seriously threaten organ viability and patient life if not recognized promptly. Clinical presentations in children are often non-specific, making diagnostic imaging pivotal. Objectives: To describe the characteristic imaging features of common and uncommon types of organ torsion through a case series, systematize pathognomonic signs, and evaluate the role of imaging modalities in guiding management.

Subjects and Methods: A case series report combined with a literature review of midgut volvulus, omental torsion, testicular torsion, torsion of the appendix epididymis, and ovarian torsion diagnosed and treated at Tam Anh General Hospital, HCMC between January 2025 and February 2026.

Results: Detailed analysis of 5 representative clinical cases was performed. Color Doppler ultrasound played a dominant role in detecting direct morphological and hemodynamic signs. The "whirlpool sign" was identified as the kinetic common denominator with the highest specificity for torsion conditions.

Discussion: The study comprehensively analyzes the mechanism of the whirlpool sign, limitations of color Doppler such as dual blood supply pitfalls in ovarian torsion or incomplete torsion, and establishes an imaging strategy based on age groups and ALARA radiation safety principles.

Conclusion: Early recognition of the whirlpool sign and morphological alterations on ultrasound allows accurate diagnosis, optimizing the golden window for organ-preserving surgical intervention.