Midgut volvulus

Case contributed by Oqba Abdul-nafi'
Diagnosis almost certain

Presentation

Abdominal pain and vomiting

Patient Data

Age: 20 years
Gender: Male
ct

Dilated stomach and proximal part of duodenum, which starts to whirl around the superior mesenteric vessels distally, giving the whirlpool sign, inverted SMA/SMV relationship, all the small bowel loops are located on the right side,the cecum is elevated, Findings are in keeping with midgut volvulus. The distal bowel loops are collapsed. Normal enhancement of bowel wall. No free fluid.

Case Discussion

The whirlpool sign of twisted mesentery, malrotated bowel configuration, inverted SMA/SMV relationship and proximal bowel obstruction are all important signs that guide to the diagnosis of midgut volvulus on CT scan.

Case courtesy of Prof.Mohammed A. Al-jiboori, consultant radiologist.

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