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Whirlpool sign

Dr MT Niknejad and Dr Frank Gaillard et al.

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.