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December 1975

Gravity as Cause of "Colon Cutoff"

Author Affiliations

Hamilton, Ontario

Arch Surg. 1975;110(12):1518. doi:10.1001/archsurg.1975.01360180088029

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To the Editor.—Adams, in his article entitled "Adynamic Ileus of the Colon" (Arch Surg 109:503-507, 1974), found that the plain film of the abdomen often showed an apparent cutoff in the distended colon at the splenic flexure. In a subsequent letter to the editor, Euphrat (Arch Surg 110:224-225, 1975) suggested that this was due to kinking of the colon. Actually, this apparent cutoff is easily explained by gravity. When the patient is in the supine position, the transverse colon is elevated and tends to fill with gas, while the descending colon, which is in a dependent position, may be collapsed or filled with fluid. In either case, there will be an apparent cutoff in the gas-distended colon at the splenic flexure. In such cases, the patient may be turned into the prone position and air will outline the descending colon. An additional maneuver that we have found particularly useful is

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