The Coil-Spring Sign and Intramural Hematoma of the Proximal Small Intestine

Introduction  The presenting complaint of abdominal pain is not infrequently a great problem to the diagnostician. The addition to the literature of any seemingly pathognomonic sign or finding that can be of aid in diagnosis deserves promulgation.In 1954 Felson and Levin¹ described the x-ray finding of the "coil spring sign of the duodenum," which they noted in four of their cases and one previously described case² to be associated with intramural hematoma of the second and third portions of the duodenum. At the time of their article the five cases were the only reports of intramural hematoma of the duodenum (or small intestine) in the literature with adequate descriptions of roentgenological findings.The case presented adds another confirmed instance of association of this sign with intramural hematoma of the proximal small intestine.

Historical Background  Probably the first case of intramural hematoma of the proximal small intestine with