definition
radiologists generally only consider a twist of 180 degrees a torsion, so if an organ is twisted 175 degrees or 150 such an ocurrence is not even mentioned by most radiologists
Only a few may mention a spiralling shape, but generally it is not considered to be an illness.

In this article you can see for yourself why that  has got to change. And why  a twist of 180 degrees is to be called an acute torsion
and any other twist, even one of 25 degrees, if it would at all be noticed, should be considered and named a chronic torsion.
 
The reason is that both conditions are equally lethal, only the full torsion will kill fast and the other one will kill slowly 
(or fast when it gets to a full one, why wait for that to happen?)
The acute one will usually kill because it cuts of the blood supply or cause some sort of rupture.
The second one will cause stasis of whatever should be passing, then infection, next weakening of tissue, internal bleading and leaks.
And all of that will get further and further out of hand until one of these complications will kill. 
That is if the patient can stand the pain until then, that usually is horrendous and constant.

So it is not right a chronic torsion is often not considered to be an illness.
It should be, regardless of it’s location.



Direct cause
Torsions and spirals are rare, but  can occur in almost any organ, like the gallbladder, the oesophagus, the stomach,  the duodenum. Chronic torsions also occur in the lower GI tract but are less conspicious there, so less well known.

It is often assumed that when some organ gets into torsion the cause for the twisting is to be found inside the organ itself.
But that is usually not the case.

Normally all organs in any abdomen are suspended, and hang on ligaments.
Thus they escape the laws of gravity.
If that would not be the case the combined weight of our internal organs would be too heavy to carry around.

All torsions occur because and only when organs get loose from their ligaments
If any organ remains fixed it can hardly rotate or get twisted.

The spiralling shape is caused by  gravity getting a hold of any particular organ.
So the actual twist is caused by laws of physics more than by a medical cause.

Not only does an organ tumble and twist when it comes off of it’s ligaments,
invariably also it’s functioning is impaired.
This has been best described  and tested in case of oesophagus spirals where it is found that the contracting muscles, that usually work together harmoniously, get out of order and even seem to cause the spiral or volvulus .
This however is not the case.
The dysfunction of the muscles simply is another result of the organ coming loose from it’s ligaments because in order for the contracting muscles to apply the appropriate force, organs need to be fixed to a certain degree, or the muscles will not be able to get a grip and will slip, like a skipper on a slippery slope.
Also the muscles have to work much harder because of the malposition of the organ and usually have to push things up against gravity and the laws of nature.
They may succeed in doing so for a short while, but will fail in the end.
This second consequence of the tearing off of ligaments invariably makes matters worse.



Underlying cause
The effects of ligaments coming loose may be similar for every organ, namely a twist of some sort,
but the causes of the tearing of the ligamants can be manifold and are usually not directly located in the organ itself, allthough the gallbladder may be an exception, while even for ligaments coming loose in the same organ, like the gallbladder, there can be different causes.

Some  causes for the ligaments to get torn off are for instance;
trauma, also surgical trauma
allergies
rare illnesses
bile leaks

The tearing can also be a consequence of something else happening elsewhere in the body, 
like a hernia in the groin that can pull folds in a peritoneum that in turn may indent underlying organs untill the endless friction and pressure forces their ligaments off.
Also infection may destroy  ligaments untill they come loose
Especially in the elderly, more specific in women,  lower GI organs may get to hang or sack thus forcing upper GI organs to stretch in order to keep in touch with their lower counterparts. That stretching may also tear things off of their ligaments and cause them to spiral down.
Usually this rather slow process is not noted untill the actual spiral has been established as that is what causes quite conspicuous symptoms and problems.

Also torsions may arise in the small bowel after colostomy, virtually for the same reason; once the embrace of the colon is gone, that kept the small bowel in it's place and protected it from the forces of gravity, it  will fall prey to gravity and then twisting may very well occur



Symptoms
Basically symptoms will be similar regardless of the organ the chronic torsion will be in.
It makes a difference if an organ is twisted 25% or 75 % or 175% but not that big a difference in the end.
Any twist will narrow any passage while the muscles cannot properly contract and get dysfunctional, thus passage of whatever it is that has to pass may get more difficult to sometimes even impossible.
The more or less stasis that is a result will always lead to infections and tissue weakening
The ongoing stress on those parts to maintain passage will add to to the mix.
Internal bleeding , belching,  leakage, rupture etc etc will eventually  occur until one of these things gets out of hand and kill the patient.

Obviously a twisted gallbladder will give bile troubles, a twisted stomach will yield acid trouble and a spiralling oesophagus will cause food problems, but basically  the lack of proper passage is the issue in all cases.
 
Also Pain is always a symptom



Treatment .
if a spiralling organ cannot be removed, treatment is difficult  because re adjusting of organs in their original place has not often been done, because it has not often been noticed
It should however be tried till practice makes perfect. 

Secondary causes like a hernia or sacked down organs should be looked for and remedied if possible, to relieve the pressure on the spiralled counterpart and prevent further escalation or more torsions
Until readjustment becomes a standard procedure, treatment will remain tricky since the torn ligaments basically are the issue



summary
When any organ comes of off it’s ligaments it will tumble, twist and get dysfunctional fast or slowly, get infected and , no pun intended,  spiral more and more out of control until the consequences  escalate to deadly conditions.
In the end invariably some or other catastrophy is the result, regardless of the  location of the torsion and the degree of the twist.

It is therefor not right torsions, semi torsions, spirals and twists , or whatever one may want to call them, are still, by many doctors, not considered to be an illness.

They are to be considered very, very, very serious illnessess, because they will kill.


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