Small bowel obstruction with associated mesenteric volvulus

Case contributed by Dr Nasir Siddiqui

Presentation

This patient had a history of fallopian tube cancer and had de-bulking. Now she presents with worsening abdominal pain and distention.

Patient Data

Age: 63 years
Gender: Female

CT demonstrates a small bowel obstruction due to a midgut volvulus (note the whirlpool sign of the SMA / SMV)

Case Discussion

CT with intravenous contrast of the abdomen demonstrates swirling of the mesenteric root (whirlpool sign) with dilated loops of small bowel. The mesenteric volvulus is highly concerning for vascular compromise necessitating surgical intervention.

Differential considerations

Note that these may be radiograpically indistinguishable.

Diagnosis

Transmesenteric defect was noted on laparotomy. Appropriate bowel decompression and surgical correction was performed.

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Case information

rID: 12257
Case created: 3rd Nov 2010
Last edited: 12th Aug 2016
Inclusion in quiz mode: Included

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