The whirlpool sign of the mesentery, also known as the whirl sign, is seen when the bowel rotates around its mesentery leading to whirls of the mesenteric vessels.
Terminology
The term whirlpool sign is used in other contexts: see whirlpool sign (disambiguation).
Radiographic features
It is seen in a number of settings:
-
malrotation complicated by 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.
-
cecal volvulus and cecal bascule
- cecal volvulus and cecal bascule can have the same appearance, with whirl occurring in the cecal mesentery
- sigmoid volvulus 6
- closed loop bowel obstruction 5
- enteritis: similar pattern, but in the opposite direction has been described on ultrasound 3
- omental torsion 7
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