Midgut volvulus - ischemic

Case contributed by Foroogh Jafari Mousavi
Diagnosis certain


History of brain injury. Presents with bowel obstruction for investigation.

Patient Data

Age: 35 years
Gender: Female

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

The third part of the duodenum crosses from left to right and the duodenojejunal flexure is located on the right side. 

The small bowel loops are prominent in caliber 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 visualized.

Case Discussion

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

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