The whirlpool sign (also known as the whirl sign) is seen when bowel rotates around its mesentery, with mesenteric vessels creating the whirls. It is seen in a number of settings:
- malrotation complicated by midgut volvulus
- caecal volvulus
- enteritis : similar pattern, but in the opposite direction has been described on ultrasound 3
Malrotation and midgut volvulus
It represents the swirling appearance of the mesentery and superior mesenteric vein around the superior mesenteric artery. The direction of swirl is clockwise on ultrasound (viewed from above so-to-speak) and counter-clockwise on CT (as if viewed from below).
It is the corollary of the corkscrew sign seen on barium studies.
Caecal volvulus can have the same appearance, with whirl occurring in the caecal mesentery.
- 1. Epelman M. The whirlpool sign. Radiology. 2006;240 (3): 910-1. doi:10.1148/radiol.2403040370 - Pubmed citation
- 2. Peterson CM, Anderson JS, Hara AK et-al. Volvulus of the gastrointestinal tract: appearances at multimodality imaging. Radiographics. 29 (5): 1281-93. doi:10.1148/rg.295095011 - Pubmed citation
- 3. Shimanuki Y, Aihara T, Takano H et-al. Clockwise whirlpool sign at color Doppler US: an objective and definite sign of midgut volvulus. Radiology. 1996;199 (1): 261-4. Radiology (abstract) - Pubmed citation
- 4. Frank AJ, Goffner LB, Fruauff AA et-al. Cecal volvulus: the CT whirl sign. Abdom Imaging. 1993;18 (3): 288-9. - Pubmed citation
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