Midgut volvulus of adult

Case contributed by Dr Erik Ranschaert

Presentation

66-year old lady with acute colicky abdominal pain

Patient Data

Age: 68
Gender: Female
Modality: CT

Midgut volvulus

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.

 

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Case Information

rID: 10819
Case created: 25th Sep 2010
Last edited: 26th Nov 2016
Inclusion in quiz mode: Included

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