Midgut volvulus: ischaemic

Case contributed by Dr Foroogh Jafari Mousavi

Presentation

Background of prior brain injury. Signs of bowel obstruction ?cause.

Patient Data

Age: 33
Gender: Female
Modality: CT

Whirlpool sign (swirling of the superior mesenteric vessels),  in keeping with mid gut malrotation plus diminishing contrast medium in the more distal portion of the SMA in keeping with vascular compromise.

Third part of the duodenum crosses form left to right and the DJ flexure is located on the right side. 

The small bowel loops are prominent in calibre measuring up to 3 cm in diameter. Multiple fluid levels are seen in the small bowel. 

There is a small amount of free fluid in the abdomen and pelvis. No free air that could suggest a perforation is visualised.

Case Discussion

This patient had a rapid deterioration and was found to have ischemic gut secondary to SMA compromise in theatre, unfortunately resulting in a fatal outcome.  

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Case Information

rID: 39769
Case created: 19th Sep 2015
Last edited: 22nd Dec 2015
Inclusion in quiz mode: Included

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