![]() This upright iamge of the abdomen clearly shows that the air under the diapragm is part of air within the lumen of a loop of bowel in the right upper quadrant. See next image (Image courtesy of Ashley Davidoff M.D.) 45758 45759 The patient was asymptomatic and so a subsequent upright KUB was performed. #Right colic flexture free#This image shows a curvilinear air shadow that suggests free ar under the diaphragm. Note the fluid filled colon caused by a mucin secreting adenocarcinoma. The coronal reformat from a frail and elderly woman shows a thick walled hepatic flexure with transmural extension toward the liver. Hepatic flexure mucin secreting adenocarcinoma Occasionally an aggressive carcinoma may spread directly from the colon to the liver or gallbladder, making surgical resection difficult. The close relationship of this part of the colon with the liver and gallbladder is sometimes relevant in disease. This CT study shows a redundant complex turn of the hepatic flexure. It is commonly redundant and it may be difficult to uncoil this redundancy with a barium enema. The hepatic flexure is not always a simple 90 degree turn. It is commonly redundant and it may be difficult radiologically to uncoil this redundancy with a barium enema making it difficult to fully visualize all parts of the flexure. ![]() The beginning and end of the hepatic flexure are ill defined, but it connects the ascending colon with the transverse colon. The hepatic flexure receives its blood supply in part from the right colic vessels and in part from the middle colic vessels Normal hepatic flexure There are no defining structural changes, other than for the endoscopist trying to navigate the colon who may be able to see the dark extrinsic impression of the liver on the colon, thus marking the distinction between the end of the ascending and beginning of transverse colon. The hepatic flexure is the junction between the transverse colon and the ascending colon. ![]()
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