Midgut volvulus - adult

Case contributed by Erik Ranschaert
Diagnosis almost certain

Presentation

Acute colicky abdominal pain.

Patient Data

Age: 70 years
Gender: Female
ct

In this case, the typical CT findings of malrotation with midgut volvulus can be seen. The CT whirl or whirlpool sign describes the swirling appearance of bowel and mesentery twisted around the SMA axis. Additional CT finding is the distension of several small bowel loops due to obstruction.

Case Discussion

Midgut volvulus is a complication of malrotation in which clockwise twisting of the bowel (whirlpool sign) around the SMA axis occurs because of the narrowed mesenteric attachment. This life-threatening condition is a clear indication for emergent surgery. 

The clinical diagnosis of midgut volvulus in adolescents and adults is difficult because the presentation is usually nonspecific and malrotation is rarely considered. Recurrent episodes of colicky abdominal pain with vomiting over a period of months or years are typical and may eventually lead to imaging.

 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.