In this inaugural case of the week radiology lecture, we discuss the imaging appearance of cecal volvulus! Key points include: * Cecal volvulus occurs when there is twisting of cecum around the mesentery with proximal large bowel obstruction. * Cecum normally 9 cm, rest of large bowel 6 cm. * Topogram (scout view) extremely helpful. * Vector typically points towards LUQ, but instead of worrying about vector direction, look for proximal dilated small bowel (as opposed to large bowel) to differentiate from sigmoid volvulus. * Complications include pneumoperitoneum = bowel perforation (Rigler’s sign, falciform ligament sign) and pneumatosis = cecal ischemia.